Provider Demographics
NPI:1386050128
Name:STELLIAN CARE SYSTEMS
Entity type:Organization
Organization Name:STELLIAN CARE SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAASTRUP
Authorized Official - Suffix:SR
Authorized Official - Credentials:CAREGIVER
Authorized Official - Phone:567-219-1755
Mailing Address - Street 1:4422 SHERI LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-5635
Mailing Address - Country:US
Mailing Address - Phone:567-219-1755
Mailing Address - Fax:
Practice Address - Street 1:4422 SHERI LN
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-5635
Practice Address - Country:US
Practice Address - Phone:567-219-1755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care