Provider Demographics
NPI:1740618396
Name:STAR QUALITY NURSING AGENCY
Entity Type:Organization
Organization Name:STAR QUALITY NURSING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-454-9070
Mailing Address - Street 1:99 NW 183RD ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4502
Mailing Address - Country:US
Mailing Address - Phone:305-454-9070
Mailing Address - Fax:305-705-3256
Practice Address - Street 1:99 NW 183RD ST
Practice Address - Street 2:SUITE 230
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4502
Practice Address - Country:US
Practice Address - Phone:305-454-9070
Practice Address - Fax:305-705-3256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211665251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health