Provider Demographics
NPI:1093946980
Name:STARLITE COMMUNITY SERVICES
Entity Type:Organization
Organization Name:STARLITE COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERN/VOLUNTEER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:NICOLAS
Authorized Official - Last Name:HOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-206-3656
Mailing Address - Street 1:2818 MONTE CRESTA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-2245
Mailing Address - Country:US
Mailing Address - Phone:408-206-3656
Mailing Address - Fax:
Practice Address - Street 1:2818 MONTE CRESTA WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95132-2245
Practice Address - Country:US
Practice Address - Phone:408-206-3656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health