Provider Demographics
NPI:1285022616
Name:ALL-STAR FAMILY PROVIDERS LLC
Entity Type:Organization
Organization Name:ALL-STAR FAMILY PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PITZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-667-7969
Mailing Address - Street 1:105 MYERS LN
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16102-3523
Mailing Address - Country:US
Mailing Address - Phone:724-667-7969
Mailing Address - Fax:
Practice Address - Street 1:105 MYERS LN
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16102-3523
Practice Address - Country:US
Practice Address - Phone:724-667-7969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA43115391251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services