Provider Demographics
NPI:1497150254
Name:STAR HOME CARE
Entity Type:Organization
Organization Name:STAR HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:DESMOND
Authorized Official - Last Name:HLAVATY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-880-7089
Mailing Address - Street 1:350 W PASSAIC ST
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3073
Mailing Address - Country:US
Mailing Address - Phone:201-880-7089
Mailing Address - Fax:201-880-7090
Practice Address - Street 1:350 W PASSAIC ST
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3073
Practice Address - Country:US
Practice Address - Phone:201-880-7089
Practice Address - Fax:201-880-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0194100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health