Provider Demographics
NPI:1629831755
Name:MORNING-STAR GROUP HOME LLC
Entity Type:Organization
Organization Name:MORNING-STAR GROUP HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADWOA
Authorized Official - Middle Name:
Authorized Official - Last Name:KWARTEMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:157-120-1616
Mailing Address - Street 1:4129 CATLETT RD
Mailing Address - Street 2:
Mailing Address - City:CATLETT
Mailing Address - State:VA
Mailing Address - Zip Code:20119-2163
Mailing Address - Country:US
Mailing Address - Phone:571-201-6160
Mailing Address - Fax:
Practice Address - Street 1:4129 CATLETT RD
Practice Address - Street 2:
Practice Address - City:CATLETT
Practice Address - State:VA
Practice Address - Zip Code:20119-2163
Practice Address - Country:US
Practice Address - Phone:571-201-6160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health