Provider Demographics
NPI:1205053048
Name:MORNING STAR HOME CARE LLC
Entity type:Organization
Organization Name:MORNING STAR HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ONYEJOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-739-1515
Mailing Address - Street 1:349 CENTERVILLE ROAD BLDG 6
Mailing Address - Street 2:BLDG 6
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886
Mailing Address - Country:US
Mailing Address - Phone:401-739-1515
Mailing Address - Fax:401-739-1116
Practice Address - Street 1:349 CENTERVILLE ROAD BLDG 6
Practice Address - Street 2:BLDG 6
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886
Practice Address - Country:US
Practice Address - Phone:401-739-1515
Practice Address - Fax:401-739-1116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIHNC02320251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMS62433Medicaid