Provider Demographics
NPI:1578515656
Name:STARLIGHT HEALTHCARE SERVICES,LLC
Entity Type:Organization
Organization Name:STARLIGHT HEALTHCARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:316-686-0333
Mailing Address - Street 1:3700 E DOUGLAS AVE
Mailing Address - Street 2:SUITE #60
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3700
Mailing Address - Country:US
Mailing Address - Phone:316-686-0333
Mailing Address - Fax:316-686-0327
Practice Address - Street 1:3700 E DOUGLAS AVE
Practice Address - Street 2:SUITE #60
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3700
Practice Address - Country:US
Practice Address - Phone:316-686-0333
Practice Address - Fax:316-686-0327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty