Provider Demographics
NPI:1659661809
Name:ALL STAR PRIMARY HOME CARE, LLC
Entity Type:Organization
Organization Name:ALL STAR PRIMARY HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-624-5555
Mailing Address - Street 1:4201 N. 22ND ST.
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4143
Mailing Address - Country:US
Mailing Address - Phone:956-624-5555
Mailing Address - Fax:956-618-3110
Practice Address - Street 1:4201 N. 22ND ST.
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4143
Practice Address - Country:US
Practice Address - Phone:956-624-5555
Practice Address - Fax:956-618-3110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility