Provider Demographics
NPI:1477890705
Name:STAR OF MARIS HOME HEALTH INC.
Entity Type:Organization
Organization Name:STAR OF MARIS HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALT.ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:UCHE
Authorized Official - Last Name:IHEGWORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-773-1999
Mailing Address - Street 1:10103 FONDREN RD
Mailing Address - Street 2:SUITE 462
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4556
Mailing Address - Country:US
Mailing Address - Phone:713-773-1999
Mailing Address - Fax:
Practice Address - Street 1:10103 FONDREN RD
Practice Address - Street 2:SUITE 462
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4556
Practice Address - Country:US
Practice Address - Phone:713-773-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care