Provider Demographics
NPI:1124255476
Name:STARCARE
Entity type:Organization
Organization Name:STARCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DIDACUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ONODINGENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-367-0513
Mailing Address - Street 1:1161 MURFREESBORO PIKE
Mailing Address - Street 2:SUITE 523
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2222
Mailing Address - Country:US
Mailing Address - Phone:615-367-0513
Mailing Address - Fax:
Practice Address - Street 1:1161 MURFREESBORO PIKE
Practice Address - Street 2:SUITE 523
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37217-2222
Practice Address - Country:US
Practice Address - Phone:615-367-0513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-14
Last Update Date:2009-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No253J00000XAgenciesFoster Care Agency
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00E09OtherDMRS