MEDICARE: A BRITE STAR CARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1639643489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A BRITE STAR CARE SERVICES

Provider Business Mailing Address
First Line	:	3650 S EASTERN AVE STE 360
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3345
Country	:	US
Telephone Number	:	702-756-8987
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 S EASTERN AVE STE 360
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-3345
Country	:	US
Telephone Number	:	702-756-8789
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MS. CONSTANCE KELLY
Credential	:
Telephone Number	:	702-756-8987

Provider Enumeration Date	:	01/15/2019
Last Update Date	:	01/15/2019

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