Stellar Support Services LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

315P00000X Issued in OH

Legal business name

STELLAR SUPPORT SERVICES LLC

Practice address

541 West Ave Ste 1B
541 West Avenue Suite 1B
Tallmadge, OH 44278-1790

Phone

(234) 788-3314

NPI assigned

Jan 16, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Marvina Denise Williams, LSW

Title

Ceo

Phone

(234) 788-3314

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1578985115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 BYE ST",
            "address_2": "541 WEST AVENUE SUITE 1B",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443202178",
            "telephone_number": "234-788-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 WEST AVE STE 1B",
            "address_2": "541 WEST AVENUE SUITE 1B",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442781790",
            "telephone_number": "234-788-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLAR SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-16",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARVINA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "234-788-3314",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": "315P00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095420",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Stadelman
• Anna Stallard
• Michelle Stark-Miller
• Melissa Stavana
• Amy Stedman, P.T.A.
• Donald Charles Stephens III, M.D.
• Kristy E Stone
• Catherine Strickland
• Christine Stroll, PTA
• Janet P Strottner

• Intellectual Disabilities Intermediate Care Facility in Tallmadge, OH
• Providers in Tallmadge, OH by specialty
• Intellectual Disabilities Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.