Organization
AMERICAN STAR HOME 2 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
5102 SIMS MOUNTAIN COURT, ANTIOCH, CA 94531
(925) 757-4121
(925) 757-4242
Mailing address
2009 FITZGERALD WAY, BRENTWOOD, CA 94513
(923) 813-1979
(925) 757-4242
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
140000706
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LTC80357F
ICFDD-N
CA
Enumeration date
03/14/2007
Last updated
02/24/2024
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