Provider Demographics
NPI:1639765423
Name:SILVER STAR HOMECARE, LLC
Entity Type:Organization
Organization Name:SILVER STAR HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HARTOG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-406-4976
Mailing Address - Street 1:1810 E SAHARA AVE STE 217
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3707
Mailing Address - Country:US
Mailing Address - Phone:702-406-4976
Mailing Address - Fax:
Practice Address - Street 1:1810 E SAHARA AVE STE 217
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3707
Practice Address - Country:US
Practice Address - Phone:702-406-4976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty