Provider Demographics
NPI:1730448598
Name:5 STAR HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:5 STAR HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-229-2158
Mailing Address - Street 1:100 N MAIN ST
Mailing Address - Street 2:416 A
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-5273
Mailing Address - Country:US
Mailing Address - Phone:903-229-2158
Mailing Address - Fax:
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:416 A
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-5273
Practice Address - Country:US
Practice Address - Phone:903-229-2158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health