Provider Demographics
NPI:1093042053
Name:CROWN OF STARS ADC,CBA & HOME HEALTH LLC
Entity Type:Organization
Organization Name:CROWN OF STARS ADC,CBA & HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-739-2031
Mailing Address - Street 1:512 W EGLY AVE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-3726
Mailing Address - Country:US
Mailing Address - Phone:956-739-2031
Mailing Address - Fax:956-783-3122
Practice Address - Street 1:304 S ALAMO RD STE D
Practice Address - Street 2:304 S ALAMO RD SUIE D
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516-2728
Practice Address - Country:US
Practice Address - Phone:956-783-3122
Practice Address - Fax:956-783-3122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care