Provider Demographics
NPI:1164980439
Name:TRI STARR HOME CARE, LLC
Entity Type:Organization
Organization Name:TRI STARR HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERILL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOMINGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-806-1392
Mailing Address - Street 1:1609 FLANIGAN DR., UNIT H
Mailing Address - Street 2:UNIT H
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122
Mailing Address - Country:US
Mailing Address - Phone:408-921-3936
Mailing Address - Fax:408-841-9695
Practice Address - Street 1:1609 FLANIGAN DR., UNIT H
Practice Address - Street 2:UNIT H
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122
Practice Address - Country:US
Practice Address - Phone:408-921-3936
Practice Address - Fax:408-841-9695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)