Provider Demographics
NPI:1821585712
Name:FIVE STAR HOME CARE SERVICES INC.
Entity type:Organization
Organization Name:FIVE STAR HOME CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRANDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-466-5787
Mailing Address - Street 1:410 S RAMPART BLVD STE 347
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5726
Mailing Address - Country:US
Mailing Address - Phone:702-466-5787
Mailing Address - Fax:702-446-1673
Practice Address - Street 1:410 S RAMPART BLVD STE 347
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145
Practice Address - Country:US
Practice Address - Phone:702-466-5787
Practice Address - Fax:702-446-1673
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1275038838
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-17
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care