Provider Demographics
NPI:1669702114
Name:STARFISH CARES LLC
Entity type:Organization
Organization Name:STARFISH CARES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARYK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEEL- DIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-376-1922
Mailing Address - Street 1:231 E SWANSON AVE STE 25B
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7056
Mailing Address - Country:US
Mailing Address - Phone:907-376-1922
Mailing Address - Fax:907-376-1925
Practice Address - Street 1:231 E SWANSON AVE STE 25B
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7056
Practice Address - Country:US
Practice Address - Phone:907-376-1922
Practice Address - Fax:907-376-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK742113251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health