Provider Demographics
NPI:1588114540
Name:STAR HOUSE, INC.
Entity type:Organization
Organization Name:STAR HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-906-1330
Mailing Address - Street 1:8170 W SAHARA AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2067
Mailing Address - Country:US
Mailing Address - Phone:702-906-1330
Mailing Address - Fax:702-906-1339
Practice Address - Street 1:8170 W SAHARA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2067
Practice Address - Country:US
Practice Address - Phone:702-906-1330
Practice Address - Fax:702-906-1339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care