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Organization

DAYSTAR HEALTH SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DANIELLE MARIE WILLIAMS (CHIEF EXECUTIVE OFFICER)
(318) 221-0212
Entity
Organization

Contact information

Practice address
1545 LINE AVE, SUITE 209, SHREVEPORT, LA 71101-4600
(318) 221-0210
(318) 221-0210
Mailing address
1545 LINE AVE, SUITE 209, SHREVEPORT, LA 71101-4600
(318) 221-0210
(318) 221-0210

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
PCA115173
LA
253Z00000X
In Home Supportive Care Agency
Primary
PCA115173
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1884634
LA
Enumeration date
09/15/2009
Last updated
09/15/2009
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