Provider Demographics
NPI:1659916500
Name:BRITESTAR HOME HEALTHCARE
Entity Type:Organization
Organization Name:BRITESTAR HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:UMOREN
Authorized Official - Suffix:
Authorized Official - Credentials:HEALTH MANAGER
Authorized Official - Phone:937-371-0918
Mailing Address - Street 1:8629 N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1329
Mailing Address - Country:US
Mailing Address - Phone:937-371-0918
Mailing Address - Fax:
Practice Address - Street 1:8629 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1329
Practice Address - Country:US
Practice Address - Phone:937-371-0918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health