Provider Demographics
NPI:1679931901
Name:BLUE STAR HOMEHEALTH AGENCY, INC
Entity Type:Organization
Organization Name:BLUE STAR HOMEHEALTH AGENCY, INC
Other - Org Name:BLUE STAR HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALERO
Authorized Official - Middle Name:T
Authorized Official - Last Name:OKUNDIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-892-4241
Mailing Address - Street 1:1633 HAWKINS CT
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-3252
Mailing Address - Country:US
Mailing Address - Phone:469-892-4241
Mailing Address - Fax:469-892-4150
Practice Address - Street 1:1140 EMPIRE CENTRAL DR STE 630
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4393
Practice Address - Country:US
Practice Address - Phone:972-408-6409
Practice Address - Fax:214-253-2655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based