Provider Demographics
NPI:1073255832
Name:STAR RCFE
Entity Type:Organization
Organization Name:STAR RCFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SEEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:RN,PCCN, CHA, CPFM
Authorized Official - Phone:510-825-2383
Mailing Address - Street 1:9701 SARA ANN CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4241
Mailing Address - Country:US
Mailing Address - Phone:510-825-2383
Mailing Address - Fax:
Practice Address - Street 1:1907 CAVALLO RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-2713
Practice Address - Country:US
Practice Address - Phone:925-732-7364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility