# FIVE STAR HOME HEALTH, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124023494
- **Authorized official:** MR. ANTHONY NIEVES (OWNER)
- **Authorized official phone:** (310) 642-0026

## Contact information

- **Practice address:** 8616 LA TIJERA BLVD, SUITE 408, LOS ANGELES, CA 90045-3944
- **Practice address phone:** (310) 642-0026
- **Practice address fax:** (310) 642-9202
- **Mailing address:** 8616 LA TIJERA BLVD, SUITE 408, LOS ANGELES, CA 90045-3950
- **Mailing address phone:** (310) 642-0026
- **Mailing address fax:** (310) 642-9202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 980001521 | CA | Yes |

## Other

- **Enumeration date:** 06/14/2005
- **Last updated:** 02/27/2013