Organization
FIVE STAR HOME HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY NIEVES (OWNER)
(310) 642-0026
Entity
Organization
Contact information
Practice address
8616 LA TIJERA BLVD, SUITE 408, LOS ANGELES, CA 90045-3944
(310) 642-0026
(310) 642-9202
Mailing address
8616 LA TIJERA BLVD, SUITE 408, LOS ANGELES, CA 90045-3950
(310) 642-0026
(310) 642-9202
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
980001521
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA08215F
—
CA
Enumeration date
06/14/2005
Last updated
02/27/2013
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