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Organization

MORNING STAR RESIDENCE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LARRY C MATEO (LLC OFFICER)
(415) 587-6034
Entity
Organization

Contact information

Practice address
658 SHOTWELL ST, SAN FRANCISCO, CA 94110-2624
(415) 285-1368
(415) 285-1368
Mailing address
91 LAKEWOOD AVE, SAN FRANCISCO, CA 94127-2719
(415) 587-6034
(415) 587-6034

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
380540234
CA
311ZA0620X
Adult Care Home Facility
Primary
380540235
CA
311ZA0620X
Adult Care Home Facility
385600364
CA
311ZA0620X
Adult Care Home Facility
389210032
CA
311ZA0620X
Adult Care Home Facility
389210033
CA

Other

Enumeration date
09/12/2007
Last updated
07/23/2008
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