Organization
FIVESTAR HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA ANJORIN BELLO PH.D. (DIRECTOR)
(770) 507-0202
Entity
Organization
Contact information
Practice address
697 DAVIS RD, SUITE C, STOCKBRIDGE, GA 30281-3062
(770) 507-0202
Mailing address
697 DAVIS ROAD, SUITE 300, STOCKBRIDGE, GA 30281
(770) 507-0202
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
031-R-0038
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
242276454E
DCH
GA
01
—
242276454F
DCH
GA
05
—
770609166
—
GA
Enumeration date
03/06/2007
Last updated
06/28/2013
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