Provider Demographics
NPI:1720448988
Name:STELLAR CARE SERVICES LLC
Entity Type:Organization
Organization Name:STELLAR CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIES
Authorized Official - Suffix:III
Authorized Official - Credentials:MED, MS
Authorized Official - Phone:215-678-0787
Mailing Address - Street 1:1243 S RUBY ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-4807
Mailing Address - Country:US
Mailing Address - Phone:919-824-0454
Mailing Address - Fax:
Practice Address - Street 1:1243 S RUBY ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-4807
Practice Address - Country:US
Practice Address - Phone:919-824-0454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health