Organization
FIVE STAR HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARITES CASTILLO BUSTAMANTE RN BSN (ADMINISTRATOR)
(702) 248-4130
Entity
Organization
Contact information
Practice address
6140 COLEY AVE, LAS VEGAS, NV 89146-5211
(702) 248-4130
(702) 220-8735
Mailing address
6140 COLEY AVE, LAS VEGAS, NV 89146-5211
(702) 248-4130
(702) 220-8735
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
540HHA-12
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002902011
—
NV
Enumeration date
08/29/2006
Last updated
03/19/2019
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