# FIVE STAR ELITE HOME HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FSET Home Health LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205450582
- **Authorized official:** MR. DERRICK DWAYNE BLACK (OWNER/CEO)
- **Authorized official phone:** (318) 455-3433

## Contact information

- **Practice address:** 9051 MANSFIELD RD STE E3, SHREVEPORT, LA 71118-2680
- **Practice address phone:** (318) 505-9505
- **Practice address fax:** (318) 716-3378
- **Mailing address:** 9051 MANSFIELD RD STE E3, SHREVEPORT, LA 71118-2680
- **Mailing address phone:** (318) 505-9505
- **Mailing address fax:** (318) 716-3378

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/03/2020
- **Last updated:** 06/04/2020