Provider Demographics
NPI:1265321152
Name:NORTH STAR SENIOR HOME CARE,LLC
Entity type:Organization
Organization Name:NORTH STAR SENIOR HOME CARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KISHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:NAINWAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-651-6792
Mailing Address - Street 1:14801 MURDOCK ST STE 135
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1040
Mailing Address - Country:US
Mailing Address - Phone:703-651-6792
Mailing Address - Fax:
Practice Address - Street 1:14801 MURDOCK ST STE 135
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1040
Practice Address - Country:US
Practice Address - Phone:703-651-6792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care