Organization
CALIFORNIA PORTSMOUTH SQUARE ASSOCIATION
Active
Other names
Starlight Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LONNIE HOLMES MPA (EXECUTIVE DIRECTOR)
(415) 574-1213
Entity
Organization
Contact information
Practice address
686 HUMBOLDT ST, RICHMOND, CA 94805-1959
(510) 236-3388
Mailing address
686 HUMBOLDT ST, RICHMOND, CA 94805-1959
(510) 236-3388
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253J00000X
Foster Care Agency
—
—
305R00000X
Preferred Provider Organization
—
—
311Z00000X
Custodial Care Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2020
Last updated
07/10/2025
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