Organization
STELLAR SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARVINA DENISE WILLIAMS LSW (CEO)
(234) 788-3314
Entity
Organization
Contact information
Practice address
541 WEST AVE STE 1B, 541 WEST AVENUE SUITE 1B, TALLMADGE, OH 44278-1790
(234) 788-3314
Mailing address
1055 BYE ST, 541 WEST AVENUE SUITE 1B, AKRON, OH 44320-2178
(234) 788-3314
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
315P00000X
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0095420
—
OH
Enumeration date
01/16/2014
Last updated
02/11/2014
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