Provider Demographics
NPI:1982926267
Name:STAR THERAPY INC
Entity type:Organization
Organization Name:STAR THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:DASHER
Authorized Official - Last Name:SIRMANS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:404-514-4990
Mailing Address - Street 1:754 NIGHT FIRE DR
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-0737
Mailing Address - Country:US
Mailing Address - Phone:404-514-4990
Mailing Address - Fax:
Practice Address - Street 1:754 NIGHT FIRE DR
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-0737
Practice Address - Country:US
Practice Address - Phone:404-514-4990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-27
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT002610251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health