Provider Demographics
NPI:1053034579
Name:GOLD STAR CARE HOME HEALTH LLC
Entity type:Organization
Organization Name:GOLD STAR CARE HOME HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AZUCENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-579-7263
Mailing Address - Street 1:302 KINGS HWY STE 104B
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-4224
Mailing Address - Country:US
Mailing Address - Phone:956-468-2933
Mailing Address - Fax:956-297-3772
Practice Address - Street 1:302 KINGS HWY STE 104B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-4224
Practice Address - Country:US
Practice Address - Phone:956-468-2933
Practice Address - Fax:956-297-3772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty