Organization
AMERICAN STAR HOME 1 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
1209 DAKOTA AVE, SAN MATEO, CA 94401
(650) 548-1903
(650) 548-1991
Mailing address
2009 FITZGERALD WAY, BRENTWOOD, CA 94513
(925) 813-1979
(925) 420-6748
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
220000351
CA
Other
Enumeration date
05/04/2007
Last updated
02/24/2024
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