Provider Demographics
NPI:1184096950
Name:DAYSTARS ADULT ACTIVITIES CENTER, INC
Entity type:Organization
Organization Name:DAYSTARS ADULT ACTIVITIES CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANTERIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONYEMEM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:346-754-3490
Mailing Address - Street 1:4611 S MAIN ST STE 8
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4731
Mailing Address - Country:US
Mailing Address - Phone:346-754-3490
Mailing Address - Fax:832-532-7236
Practice Address - Street 1:4611 S MAIN ST STE 8
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4731
Practice Address - Country:US
Practice Address - Phone:346-754-3490
Practice Address - Fax:832-532-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2023-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty