MEDICARE: STAR HORIZON LLC

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1659198315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAR HORIZON LLC

Provider Business Mailing Address
First Line	:	2122 WEBSTER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6437
Country	:	US
Telephone Number	:	702-504-9514
Fax Number	:	702-948-5537

Provider Business Practice Location Address
First Line	:	2122 WEBSTER ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6437
Country	:	US
Telephone Number	:	702-504-9514
Fax Number	:	702-948-5537

Authorized Official
Title or Position	:	MANAGER
Name	:	CRISTINA NAVATA
Credential	:
Telephone Number	:	702-504-9514

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	09/24/2024

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Directions to “STAR HORIZON LLC ” Practice Location

Language	Start Address	Practice Location

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