Provider Demographics
NPI:1164197232
Name:STELLAR HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:STELLAR HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YVETTE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-300-2921
Mailing Address - Street 1:9900 STIRLING RD STE 103
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8073
Mailing Address - Country:US
Mailing Address - Phone:954-256-4458
Mailing Address - Fax:
Practice Address - Street 1:9900 STIRLING RD STE 103
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8073
Practice Address - Country:US
Practice Address - Phone:954-256-4458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102643400Medicaid