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General NPI Number Information
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NPI Number | 1942631692
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Entity Type | Organization
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Legal Business Name | STARLIGHT COMMUNITY SERVICES
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Dates
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Enumeration Date | 12/06/2013
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Last Update Date | 12/06/2013
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Provider Practice Location Address
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Address Line | 6737 BRET HARTE DR
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City | SAN JOSE
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State | CA
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Zip | 95120-2016
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Country | US
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Telephone | 408-550-5988
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Fax |
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Provider Business Mailing Address
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Address Line | 6737 BRET HARTE DR
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City | SAN JOSE
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State | CA
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Zip | 95120-2016
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Country | US
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Telephone | 408-550-5988
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Fax |
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Authorized Official
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Title or Position | COUNSELOR-MENTAL HEALTH
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Name | CAROL CATHERINE STRAND
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Credential |
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Telephone | 408-550-5988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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