Provider Demographics
NPI:1659791721
Name:STARLIGHT OF HEMET, LLC
Entity Type:Organization
Organization Name:STARLIGHT OF HEMET, LLC
Other - Org Name:GRAND TERRACE HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL CORRO LEGASPI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-693-5027
Mailing Address - Street 1:22737 BARTON RD
Mailing Address - Street 2:SUITE # 11
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-5262
Mailing Address - Country:US
Mailing Address - Phone:909-693-5027
Mailing Address - Fax:888-219-6448
Practice Address - Street 1:22737 BARTON RD
Practice Address - Street 2:SUITE # 11
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5262
Practice Address - Country:US
Practice Address - Phone:909-693-5027
Practice Address - Fax:888-219-6448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based