Provider Demographics
NPI:1477982205
Name:ESTRELLA REHABILITATION AND SUPPORT SERVICES INC
Entity Type:Organization
Organization Name:ESTRELLA REHABILITATION AND SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NGOZI
Authorized Official - Middle Name:CHINWE
Authorized Official - Last Name:ANEKPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-437-5573
Mailing Address - Street 1:4501 NEW BERN AVE
Mailing Address - Street 2:STE 130 #176
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1549
Mailing Address - Country:US
Mailing Address - Phone:302-437-5573
Mailing Address - Fax:
Practice Address - Street 1:4501 NEW BERN AVE
Practice Address - Street 2:STE 130 #176
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1549
Practice Address - Country:US
Practice Address - Phone:302-437-5573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health