# AMAZING STAR HOMES CORPORATION

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

## Provider details

- **NPI number:** 1235686007
- **Authorized official:** DAVID O ETUTE (PRES/CEO)
- **Authorized official phone:** (757) 819-3230

## Contact information

- **Practice address:** 861 GLENROCK RD, SUITE 114, NORFOLK, VA 23502-3720
- **Practice address phone:** (757) 819-3230
- **Practice address fax:** (757) 893-9266
- **Mailing address:** 861 GLENROCK RD, SUITE 114, NORFOLK, VA 23502-3720
- **Mailing address phone:** (757) 819-3230
- **Mailing address fax:** (757) 893-9266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 164W00000X | Licensed Practical Nurse | 0001120196 | VA | Yes |

## Other

- **Enumeration date:** 09/08/2016
- **Last updated:** 09/08/2016