Provider Demographics
NPI:1851959530
Name:STARRY KNIGHT HOME CARE LLC
Entity Type:Organization
Organization Name:STARRY KNIGHT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOTELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-648-7166
Mailing Address - Street 1:2713 PELICAN AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4279
Mailing Address - Country:US
Mailing Address - Phone:956-648-7166
Mailing Address - Fax:
Practice Address - Street 1:300 E NOLANA LOOP
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-9684
Practice Address - Country:US
Practice Address - Phone:956-648-7166
Practice Address - Fax:956-781-7830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health