Provider Demographics
NPI:1639643489
Name:A BRITE STAR CARE SERVICES
Entity Type:Organization
Organization Name:A BRITE STAR CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-756-8987
Mailing Address - Street 1:3650 S EASTERN AVE STE 360
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3345
Mailing Address - Country:US
Mailing Address - Phone:702-756-8987
Mailing Address - Fax:
Practice Address - Street 1:3650 S EASTERN AVE STE 360
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3345
Practice Address - Country:US
Practice Address - Phone:702-756-8789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health