Provider Demographics
NPI:1083902472
Name:STAR INC LIGHTING THE WAY
Entity Type:Organization
Organization Name:STAR INC LIGHTING THE WAY
Other - Org Name:STAR RUBINO FAMILY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANZHAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-846-9581
Mailing Address - Street 1:182 WOLFPIT AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-3436
Mailing Address - Country:US
Mailing Address - Phone:203-846-9581
Mailing Address - Fax:203-855-0637
Practice Address - Street 1:120 EAST AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5703
Practice Address - Country:US
Practice Address - Phone:209-855-0634
Practice Address - Fax:203-855-0637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency