Provider Demographics
NPI:1447598388
Name:STAR LIGHT LLC
Entity Type:Organization
Organization Name:STAR LIGHT LLC
Other - Org Name:FIRSTLIGHT HOME CARE OF WESTERN COLORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ASSISTANT/HR COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:PUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-417-4812
Mailing Address - Street 1:126 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-3950
Mailing Address - Country:US
Mailing Address - Phone:970-240-4864
Mailing Address - Fax:866-871-0581
Practice Address - Street 1:1048 INDEPENDENT AVE STE A119
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-6175
Practice Address - Country:US
Practice Address - Phone:970-639-2048
Practice Address - Fax:970-639-2048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
CO04D888253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care