State Health Care LTD

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

201013000811 Issued in OH

Legal business name

STATE HEALTH CARE LTD

Practice address

201 Riverside Dr Ste 2E
Dayton, OH 45405-4956

Phone

(937) 222-2537

Fax

(937) 222-2543

NPI assigned

May 26, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mohamed Barre

Title

Ceo

Phone

(937) 222-2537

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Home health agency certification: CCN 368404

Legal name

STATE HEALTH CARE LTD

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 5, 2012

Last certification

Jan 18, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

201 Riverside Drive
Suite 2E
Dayton, OH 45405-4963

Listed as

State Health Care, LTDCCN 368404

Ownership

Proprietary

Certified

Mar 5, 2012

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093034340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 RIVERSIDE DR STE 2E",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054956",
            "telephone_number": "937-222-2537",
            "fax_number": "937-222-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 RIVERSIDE DR STE 2E",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454054956",
            "telephone_number": "937-222-2537",
            "fax_number": "937-222-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE HEALTH CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BARRE",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "937-222-2537",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OH",
            "license": "201013000811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald L Stark
• Doug Stark
• Amber Starks Miller
• Carmen C Starks
• William Grant Starrett, MD
• State of Ohio Department of Mental Health
• Camela Robin Staten, INDEPENDENT PROVIDER
• Jasmine Staten
• Mary Elizabeth Staten
• Tashawna Staten, LPN

• Home Health Agency in Dayton, OH
• Providers in Dayton, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.