Provider Demographics
NPI:1225772064
Name:SEVENSTARS FAMILY CARE HOME LLC
Entity Type:Organization
Organization Name:SEVENSTARS FAMILY CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:IFEYINWA
Authorized Official - Last Name:ANYANWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-440-8333
Mailing Address - Street 1:4901 DEPARTURE DR UNIT 58771
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27658-0802
Mailing Address - Country:US
Mailing Address - Phone:919-440-8333
Mailing Address - Fax:919-646-9164
Practice Address - Street 1:3217 DEARBORN DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2344
Practice Address - Country:US
Practice Address - Phone:919-440-8333
Practice Address - Fax:919-614-9164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No253Z00000XAgenciesIn Home Supportive Care
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility