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Organization

AMERICAN STAR HOME 5 ICF/DD-N

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VICKY SANTOS TING BSN (PRESIDENT/ADMINISTRATOR/OWNER)
(925) 813-1979
Entity
Organization

Contact information

Practice address
1627 SHOREVIEW AVENUE, SAN MATEO, CA 94401-3033
(650) 579-6588
(650) 579-6590
Mailing address
2009 FITZGERALD WAY, BRENTWOOD, CA 94513-2368
(925) 813-1979
(925) 420-6748

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Enumeration date
05/26/2010
Last updated
02/24/2024
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