Provider Demographics
NPI:1871821579
Name:CARESTAR HOME HEALTH SERVICE, LLC
Entity Type:Organization
Organization Name:CARESTAR HOME HEALTH SERVICE, LLC
Other - Org Name:CARESTAR HOME HEALTH SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:KALAKKATTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-325-3816
Mailing Address - Street 1:102 BLUEBONNET CIR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-5007
Mailing Address - Country:US
Mailing Address - Phone:214-403-8949
Mailing Address - Fax:
Practice Address - Street 1:102 BLUEBONNET CIR
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-5007
Practice Address - Country:US
Practice Address - Phone:214-403-8949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health