Provider Demographics
NPI:1982268074
Name:STAR CARE SUPPORT SERVICES
Entity Type:Organization
Organization Name:STAR CARE SUPPORT SERVICES
Other - Org Name:STAR CARE SUPPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ADJEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-910-9050
Mailing Address - Street 1:60 COVENTRY CIR
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5250
Mailing Address - Country:US
Mailing Address - Phone:732-910-9050
Mailing Address - Fax:
Practice Address - Street 1:60 COVENTRY CIR
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-5250
Practice Address - Country:US
Practice Address - Phone:732-910-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1982268074Medicaid