Provider Demographics
NPI:1396082004
Name:STAR CENTER GROUP INC
Entity type:Organization
Organization Name:STAR CENTER GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KESHISHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-821-6854
Mailing Address - Street 1:5958 VINELAND AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-1329
Mailing Address - Country:US
Mailing Address - Phone:818-821-6854
Mailing Address - Fax:818-821-6856
Practice Address - Street 1:5958 VINELAND AVE
Practice Address - Street 2:SUITE K
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-1329
Practice Address - Country:US
Practice Address - Phone:818-579-4342
Practice Address - Fax:818-821-6856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health