Provider Demographics
NPI:1366715732
Name:STAR ADULT DAY CARE CENTER
Entity type:Organization
Organization Name:STAR ADULT DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIA
Authorized Official - Middle Name:DORINA
Authorized Official - Last Name:LUCACI
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:248-469-7111
Mailing Address - Street 1:28975 GRAND RIVER
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336
Mailing Address - Country:US
Mailing Address - Phone:248-469-7111
Mailing Address - Fax:
Practice Address - Street 1:28975 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5831
Practice Address - Country:US
Practice Address - Phone:248-469-7111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization