Organization
DOTNA STAR LLC
Active
Other names
DOTNA HOME CARE AGENCY
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY EDMUND GROSS LVN (ADMINISTRATOR)
(469) 347-0609
Entity
Organization
Contact information
Practice address
17811 VAIL ST, APT 20202, DALLAS, TX 75287-6460
(469) 347-0609
Mailing address
17811 VAIL ST, APT 20202, DALLAS, TX 75287-6460
(469) 347-0609
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
802397878
—
TX
Enumeration date
03/23/2016
Last updated
03/23/2016
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