Provider Demographics
NPI:1881838449
Name:GOOD SHEPHERD HOLDINGS CORP
Entity Type:Organization
Organization Name:GOOD SHEPHERD HOLDINGS CORP
Other - Org Name:BRIGHTSTAR HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-685-5448
Mailing Address - Street 1:16 E 3RD AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-4033
Mailing Address - Country:US
Mailing Address - Phone:650-685-5448
Mailing Address - Fax:650-685-5549
Practice Address - Street 1:16 E 3RD AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-4033
Practice Address - Country:US
Practice Address - Phone:650-685-5448
Practice Address - Fax:650-685-5549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care