Provider Demographics
NPI:1043041544
Name:BRIGHTSTAR HOME SERVICES LLC
Entity type:Organization
Organization Name:BRIGHTSTAR HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SODIQ
Authorized Official - Middle Name:
Authorized Official - Last Name:RASAQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-378-0675
Mailing Address - Street 1:5125 GOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-4716
Mailing Address - Country:US
Mailing Address - Phone:419-378-0675
Mailing Address - Fax:
Practice Address - Street 1:5125 GOLDEN RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-4716
Practice Address - Country:US
Practice Address - Phone:419-378-0675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty