Provider Demographics
NPI:1396376778
Name:STAR OF DAVID HOME HEALTHCARE
Entity Type:Organization
Organization Name:STAR OF DAVID HOME HEALTHCARE
Other - Org Name:STAR OF DAVID HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISREAL
Authorized Official - Middle Name:CORNELIUS
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-275-2686
Mailing Address - Street 1:3122 SPRINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5101
Mailing Address - Country:US
Mailing Address - Phone:832-275-2686
Mailing Address - Fax:866-292-3523
Practice Address - Street 1:3122 SPRINGDALE DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5101
Practice Address - Country:US
Practice Address - Phone:183-227-5268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAR OF DAVID HOME HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-04
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty