Provider Demographics
NPI:1063298578
Name:HOMECARE STAR LLC
Entity type:Organization
Organization Name:HOMECARE STAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHANAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSHAMMARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-507-6966
Mailing Address - Street 1:6717 GOLDENWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-2086
Mailing Address - Country:US
Mailing Address - Phone:916-507-6966
Mailing Address - Fax:
Practice Address - Street 1:5705 MARCONI AVE STE 9
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-4470
Practice Address - Country:US
Practice Address - Phone:916-507-6966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care