Provider Demographics
NPI:1821430737
Name:STAR SUPPORT SERVICES, LLC
Entity Type:Organization
Organization Name:STAR SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:606-392-3847
Mailing Address - Street 1:55 INNER BANK DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-6542
Mailing Address - Country:US
Mailing Address - Phone:606-392-3847
Mailing Address - Fax:
Practice Address - Street 1:55 INNER BANK DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-6542
Practice Address - Country:US
Practice Address - Phone:606-392-3847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child