Provider Demographics
NPI:1679236764
Name:MORNING STAR SUPPORTIVE SERVICES CORPORATION
Entity Type:Organization
Organization Name:MORNING STAR SUPPORTIVE SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HALIMAT
Authorized Official - Middle Name:S
Authorized Official - Last Name:AKANBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-312-8522
Mailing Address - Street 1:565 HAWTHORNE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-3046
Mailing Address - Country:US
Mailing Address - Phone:551-312-8522
Mailing Address - Fax:
Practice Address - Street 1:565 HAWTHORNE AVE APT 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-3046
Practice Address - Country:US
Practice Address - Phone:551-312-8522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-16
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251G00000XAgenciesHospice Care, Community Based
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No385H00000XRespite Care FacilityRespite Care