Provider Demographics
NPI:1174635205
Name:FANSI ENDEAVOR INC
Entity Type:Organization
Organization Name:FANSI ENDEAVOR INC
Other - Org Name:STAR HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:VIFANSI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:443-538-6570
Mailing Address - Street 1:8223 SPRING BRANCH CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-2031
Mailing Address - Country:US
Mailing Address - Phone:301-317-6073
Mailing Address - Fax:301-317-6073
Practice Address - Street 1:8223 SPRING BRANCH CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-2031
Practice Address - Country:US
Practice Address - Phone:301-317-6073
Practice Address - Fax:301-317-6073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health