Provider Demographics
NPI:1467173948
Name:LIVE STAR HOME CARE
Entity Type:Organization
Organization Name:LIVE STAR HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:NDUWAYO
Authorized Official - Last Name:GERVAIA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:720-365-7168
Mailing Address - Street 1:20321 KELLY PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-6927
Mailing Address - Country:US
Mailing Address - Phone:307-433-7733
Mailing Address - Fax:
Practice Address - Street 1:20321 KELLY PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-6927
Practice Address - Country:US
Practice Address - Phone:307-433-7733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care