Provider Demographics
NPI:1073960316
Name:ALL STAR IN HOME CARE LLC
Entity Type:Organization
Organization Name:ALL STAR IN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FAZEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:314-609-9029
Mailing Address - Street 1:514 BROOK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-3711
Mailing Address - Country:US
Mailing Address - Phone:314-609-9029
Mailing Address - Fax:
Practice Address - Street 1:514 BROOK MEADOW DR
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63021-3711
Practice Address - Country:US
Practice Address - Phone:314-609-9029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC1383420251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health