MEDICARE: A STARLIGHT PERSONAL CARE, 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	251E00000X	Home Health Agency	NV20171685973	NV

General Provider Information

NPI Number	:	1982106480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A STARLIGHT PERSONAL CARE, LLC

Provider Business Mailing Address
First Line	:	2801 S VALLEY VIEW BLVD STE 11
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0176
Country	:	US
Telephone Number	:	702-202-0978
Fax Number	:	702-202-4882

Provider Business Practice Location Address
First Line	:	2801 S VALLEY VIEW BLVD STE 11
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0176
Country	:	US
Telephone Number	:	702-202-0978
Fax Number	:	702-202-4882

Authorized Official
Title or Position	:	OWNER
Name	:	SERZH ARAKELYAN
Credential	:
Telephone Number	:	702-202-0978

Provider Enumeration Date	:	03/01/2018
Last Update Date	:	01/10/2022

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