Provider Demographics
NPI:1598806911
Name:4 STAR HOME HEALTHCARE, INC
Entity Type:Organization
Organization Name:4 STAR HOME HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOBAR
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-613-9440
Mailing Address - Street 1:17520 W 12 MILE RD
Mailing Address - Street 2:108
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1945
Mailing Address - Country:US
Mailing Address - Phone:248-613-9440
Mailing Address - Fax:
Practice Address - Street 1:17520 W 12 MILE RD STE 108
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1944
Practice Address - Country:US
Practice Address - Phone:248-613-9440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health