Provider Demographics
NPI:1710395272
Name:LIFE STAR HOME CARE
Entity Type:Organization
Organization Name:LIFE STAR HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARSHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANIAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-468-1888
Mailing Address - Street 1:1015 E BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1370
Mailing Address - Country:US
Mailing Address - Phone:614-468-1888
Mailing Address - Fax:614-468-1099
Practice Address - Street 1:1015 E BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1370
Practice Address - Country:US
Practice Address - Phone:614-468-1888
Practice Address - Fax:614-468-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0095551Medicaid