Provider Demographics
NPI:1174847388
Name:5 - STAR LUXURY LIVING
Entity Type:Organization
Organization Name:5 - STAR LUXURY LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:KYLE-CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-973-9273
Mailing Address - Street 1:4802 LAZY TIMBERS DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4455
Mailing Address - Country:US
Mailing Address - Phone:281-973-9273
Mailing Address - Fax:866-447-8979
Practice Address - Street 1:4802 LAZY TIMBERS DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-4455
Practice Address - Country:US
Practice Address - Phone:281-973-9273
Practice Address - Fax:866-447-8979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health