Provider Demographics
NPI:1871903906
Name:STAR LEADERS
Entity type:Organization
Organization Name:STAR LEADERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEASAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-705-3424
Mailing Address - Street 1:1313 N PINE HILLS RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32808-4833
Mailing Address - Country:US
Mailing Address - Phone:407-601-0659
Mailing Address - Fax:888-512-3620
Practice Address - Street 1:15493 STONEYBROOK WEST PKWY
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4769
Practice Address - Country:US
Practice Address - Phone:407-705-3424
Practice Address - Fax:407-289-2102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management