Provider Demographics
NPI:1700231792
Name:STAR HOME CARE AND COMPANION SERVICES INC
Entity Type:Organization
Organization Name:STAR HOME CARE AND COMPANION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YUDERCA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARBERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-331-8690
Mailing Address - Street 1:4100 CORPORATE SQ
Mailing Address - Street 2:SUITE 151
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-4714
Mailing Address - Country:US
Mailing Address - Phone:239-331-8690
Mailing Address - Fax:239-643-6628
Practice Address - Street 1:1840 W 49TH ST
Practice Address - Street 2:SUITE 502
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2942
Practice Address - Country:US
Practice Address - Phone:239-331-8690
Practice Address - Fax:239-643-9968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL232728253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL232728OtherAHCA
FL232681OtherAHCA
FL005937900Medicaid