Provider Demographics
NPI:1457707275
Name:DAYSTAR HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:DAYSTAR HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:OJO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-361-7871
Mailing Address - Street 1:8230 BOONE BLVD
Mailing Address - Street 2:SUITE 430
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2621
Mailing Address - Country:US
Mailing Address - Phone:202-361-7871
Mailing Address - Fax:
Practice Address - Street 1:8230 BOONE BLVD
Practice Address - Street 2:SUITE 430
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2621
Practice Address - Country:US
Practice Address - Phone:202-361-7871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management