Stellar Support Service

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

STELLAR SUPPORT SERVICE

Practice address

15009 North Preston Highway
Suite a
Bruceton Mills, WV 26525

Phone

(681) 270-9223

NPI assigned

Jul 5, 2021

Last updated

Jul 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vickie D'Avanzo

Title

Ceo

Phone

(412) 996-6263

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stellar Support Service Other name

Locations

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

{
    "created_epoch": "1625443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1992376651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W 5TH AVE",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151323503",
            "telephone_number": "412-996-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15009 NORTH PRESTON HIGHWAY",
            "address_2": "SUITE A",
            "city": "BRUCETON MILLS",
            "state": "WV",
            "postal_code": "26525",
            "telephone_number": "681-270-9223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLAR SUPPORT SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-05",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-01",
        "status": "A",
        "authorized_official_last_name": "D'AVANZO",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "412-996-6263"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103235783",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stellar Support Service",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Stellar Support Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Developmentally Disabled Services Day Training Agency in Bruceton Mills, WV
• Providers in Bruceton Mills, WV by specialty
• Developmentally Disabled Services Day Training Agency in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.