Provider Demographics
NPI:1104602564
Name:MORNING STAR ADULT FAMILY CARE HOME, INC.
Entity type:Organization
Organization Name:MORNING STAR ADULT FAMILY CARE HOME, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIETA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTIBLANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-719-2926
Mailing Address - Street 1:PO BOX 33027
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33420-3027
Mailing Address - Country:US
Mailing Address - Phone:561-719-2926
Mailing Address - Fax:888-241-9661
Practice Address - Street 1:3387 RCA BLVD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3221
Practice Address - Country:US
Practice Address - Phone:561-719-2926
Practice Address - Fax:888-241-9661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty