Provider Demographics
NPI:1407055544
Name:SUPERSTAR HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:SUPERSTAR HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-221-7077
Mailing Address - Street 1:4815 NW 79TH AVE STE 17
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5437
Mailing Address - Country:US
Mailing Address - Phone:305-221-7077
Mailing Address - Fax:305-221-7078
Practice Address - Street 1:4815 NW 79TH AVE STE 17
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5437
Practice Address - Country:US
Practice Address - Phone:305-221-7077
Practice Address - Fax:305-221-7078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL800022488251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health