Provider Demographics
NPI:1992732531
Name:STAR OF LIFE HOME CARE INC
Entity type:Organization
Organization Name:STAR OF LIFE HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING / ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOURIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-568-0111
Mailing Address - Street 1:2919 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-2634
Mailing Address - Country:US
Mailing Address - Phone:956-568-0111
Mailing Address - Fax:956-753-0112
Practice Address - Street 1:2919 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040
Practice Address - Country:US
Practice Address - Phone:956-568-0111
Practice Address - Fax:956-753-0112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010364251E00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
679661Medicare Oscar/Certification