Provider Demographics
NPI:1467866632
Name:ALL STAR FAMILY HOMECARE
Entity Type:Organization
Organization Name:ALL STAR FAMILY HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:JULES
Authorized Official - Suffix:
Authorized Official - Credentials:SW
Authorized Official - Phone:781-767-6077
Mailing Address - Street 1:51 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4636
Mailing Address - Country:US
Mailing Address - Phone:617-888-7143
Mailing Address - Fax:
Practice Address - Street 1:51 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4636
Practice Address - Country:US
Practice Address - Phone:617-888-7143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAR03502251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health