Provider Demographics
NPI:1003194358
Name:STAR COMMUNITY LIVING INC
Entity Type:Organization
Organization Name:STAR COMMUNITY LIVING INC
Other - Org Name:STAR COMMUNITY LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MADUKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-537-3207
Mailing Address - Street 1:7639 BEECHNUT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-4301
Mailing Address - Country:US
Mailing Address - Phone:832-537-3207
Mailing Address - Fax:713-773-1739
Practice Address - Street 1:7639 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4301
Practice Address - Country:US
Practice Address - Phone:832-537-3207
Practice Address - Fax:713-773-1739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities