Stella Grove Health LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

STELLA GROVE HEALTH LLC

Practice address

321 Thoroughbred LN
Evans, GA 30809-4107

Phone

(404) 759-6625

NPI assigned

Oct 29, 2021

Organization subpart

No

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

Authorized official

Name

Dominique Devon Stewart

Title

Administrator - Owner

Phone

(404) 759-6625

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1396409918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 THOROUGHBRED LN",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094107",
            "telephone_number": "404-759-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 THOROUGHBRED LN",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094107",
            "telephone_number": "404-759-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLA GROVE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-29",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_middle_name": "DEVON",
        "authorized_official_title_or_position": "ADMINISTRATOR - OWNER",
        "authorized_official_telephone_number": "404-759-6625"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Elizabeth Stansell
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• Stephanie Lynn Steed
• Victorie Noelle Steed, MS OTR/L
• Kelly Bain Steele, O.D.
• Stellar ABA Therapy LLC
• Stephanie Steed Therapy LLC
• Charish Eylce Stephens
• Rachel Stephens
• Roslyn Stephens

• In Home Supportive Care Agency in Evans, GA
• Providers in Evans, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.