Provider Demographics
NPI:1407220080
Name:S.T.A.R. HOME HEALTH, LLC
Entity Type:Organization
Organization Name:S.T.A.R. HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CRIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-518-5956
Mailing Address - Street 1:29 N MARGUERITE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63135-2339
Mailing Address - Country:US
Mailing Address - Phone:314-801-8650
Mailing Address - Fax:314-801-8651
Practice Address - Street 1:2138 WOODSON RD
Practice Address - Street 2:SUITE #1
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-5671
Practice Address - Country:US
Practice Address - Phone:314-801-8650
Practice Address - Fax:314-801-8651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC001467109251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health