Provider Demographics
NPI:1790520229
Name:FIVE STAR HOME CARE
Entity type:Organization
Organization Name:FIVE STAR HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:GAVNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:650-814-0056
Mailing Address - Street 1:710 SANTA SUSANA ST
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3470
Mailing Address - Country:US
Mailing Address - Phone:650-814-0056
Mailing Address - Fax:650-396-3114
Practice Address - Street 1:830 STEWART DR STE 151
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4513
Practice Address - Country:US
Practice Address - Phone:650-814-0056
Practice Address - Fax:650-396-3114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health