Provider Demographics
NPI:1144905217
Name:LIGHTSTAR HOME CARE
Entity type:Organization
Organization Name:LIGHTSTAR HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HASHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:JUMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-306-9715
Mailing Address - Street 1:1242 MAIN ST STE 314
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1916
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1242 MAIN ST STE 314
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1916
Practice Address - Country:US
Practice Address - Phone:413-306-9715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health