Provider Demographics
NPI:1467235671
Name:ESTELLA HEALTH LLC
Entity Type:Organization
Organization Name:ESTELLA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:THEOHARIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-694-6687
Mailing Address - Street 1:115 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6528
Mailing Address - Country:US
Mailing Address - Phone:508-694-6687
Mailing Address - Fax:
Practice Address - Street 1:115 BROOK RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-6528
Practice Address - Country:US
Practice Address - Phone:508-694-6687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COASTAL MEDICAL TRANSPORTATION SYSTEMS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health