Provider Demographics
NPI:1841857943
Name:STELLAR HOME CARE AGENCY
Entity type:Organization
Organization Name:STELLAR HOME CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN/MHA
Authorized Official - Phone:803-487-6830
Mailing Address - Street 1:1213 ETTRICK AVE
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2987
Mailing Address - Country:US
Mailing Address - Phone:803-487-6830
Mailing Address - Fax:
Practice Address - Street 1:1213 ETTRICK AVE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2987
Practice Address - Country:US
Practice Address - Phone:803-487-6830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health