Provider Demographics
NPI:1619349602
Name:A STELLAR LIFE LLC
Entity Type:Organization
Organization Name:A STELLAR LIFE LLC
Other - Org Name:BRIGHTSTAR CARE OF HENDERSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCINTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-608-8811
Mailing Address - Street 1:40 E HORIZON RIDGE PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-7930
Mailing Address - Country:US
Mailing Address - Phone:702-608-8811
Mailing Address - Fax:702-608-8598
Practice Address - Street 1:40 E HORIZON RIDGE PKWY STE 103
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-7930
Practice Address - Country:US
Practice Address - Phone:702-608-8811
Practice Address - Fax:702-608-8598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8292HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health