Organization
STELLAR SUPPORT SERVICE
Active
Other names
Stellar Support Service
Organization subpart
No
Provider details
NPI number
Authorized official
VICKIE D'AVANZO (CEO)
(412) 996-6263
Entity
Organization
Contact information
Practice address
15009 NORTH PRESTON HIGHWAY, SUITE A, BRUCETON MILLS, WV 26525
(681) 270-9223
Mailing address
620 W 5TH AVE, MCKEESPORT, PA 15132-3503
(412) 996-6263
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103235783
—
PA
Enumeration date
07/05/2021
Last updated
07/12/2022
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