Provider Demographics
NPI:1326431826
Name:STELLAR HEALTH SYSTEMS PLLC
Entity Type:Organization
Organization Name:STELLAR HEALTH SYSTEMS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:OKETOKUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-491-8218
Mailing Address - Street 1:1818 NEW YORK AVE NE
Mailing Address - Street 2:SUITE 110 C
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-1848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1818 NEW YORK AVE NE
Practice Address - Street 2:SUITE 110 C
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1848
Practice Address - Country:US
Practice Address - Phone:202-636-5136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
DCMD 038372261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)