Provider Demographics
NPI:1104254242
Name:BLUE STAR HOSPICE, INC
Entity type:Organization
Organization Name:BLUE STAR HOSPICE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:ESTHER
Authorized Official - Last Name:ROSSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-727-9119
Mailing Address - Street 1:423 MASON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6232
Mailing Address - Country:US
Mailing Address - Phone:832-727-9119
Mailing Address - Fax:832-204-8414
Practice Address - Street 1:423 MASON PARK BLVD STE A1
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450
Practice Address - Country:US
Practice Address - Phone:832-727-9119
Practice Address - Fax:832-204-8414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based