Provider Demographics
NPI:1467117614
Name:MORNING STAR SUPPORTIVE SERVICES LLC
Entity Type:Organization
Organization Name:MORNING STAR SUPPORTIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUSUDEEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:AKANBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-312-8522
Mailing Address - Street 1:1201 N MARKET ST STE 111
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1156
Mailing Address - Country:US
Mailing Address - Phone:551-312-8522
Mailing Address - Fax:
Practice Address - Street 1:1201 N MARKET ST STE 111
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1156
Practice Address - Country:US
Practice Address - Phone:551-312-8522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORNING STAR SUPPORTIVE SERVICES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty