Provider Demographics
NPI:1942073457
Name:GRAHAM STAR ENTERPRISES
Entity Type:Organization
Organization Name:GRAHAM STAR ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:762-930-8008
Mailing Address - Street 1:2416 SUNFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-6452
Mailing Address - Country:US
Mailing Address - Phone:706-930-8008
Mailing Address - Fax:
Practice Address - Street 1:2416 SUNFLOWER DR
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-6452
Practice Address - Country:US
Practice Address - Phone:706-930-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRAHAM STAR ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care