| Organization Name: | CROWN OF STARS ADC,CBA & HOME HEALTH LLC |
| NPI Number: | 1093042053 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANA SOTELO (REGISTERED NURSE) |
| Mailing Address: | 304 S Alamo Rd Ste D 304 S Alamo Rd Suie D Alamo |
| State: | TX US |
| Postal Code: | 785162728 |
| Phone Number: | 9567833122 |
| Fax Number: | 9567833122 |
| NPI Enumeration Date: | 11/12/2009 |
| NPI Last Update Date: | 11/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA0600X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Adult Day Care |
| Taxonomy Definition: | |