Provider Demographics
NPI:1275140345
Name:HEALTHSTAR HOME HEALTH, LLC
Entity Type:Organization
Organization Name:HEALTHSTAR HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACI
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC-SLP
Authorized Official - Phone:915-779-7827
Mailing Address - Street 1:6800 GATEWAY BLVD E BLDG 4AB
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-1040
Mailing Address - Country:US
Mailing Address - Phone:915-779-7827
Mailing Address - Fax:915-779-7829
Practice Address - Street 1:6800 GATEWAY BLVD E BLDG 4AB
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1040
Practice Address - Country:US
Practice Address - Phone:915-779-7827
Practice Address - Fax:915-779-7829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health