Provider Demographics
NPI:1669797759
Name:HOMESTART
Entity type:Organization
Organization Name:HOMESTART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CHILDREN & FAMILY SERVICE
Authorized Official - Prefix:MS
Authorized Official - First Name:VICKEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-284-2812
Mailing Address - Street 1:30 LAS COLINAS LN
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1212
Mailing Address - Country:US
Mailing Address - Phone:408-284-2812
Mailing Address - Fax:
Practice Address - Street 1:30 LAS COLINAS LN
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1212
Practice Address - Country:US
Practice Address - Phone:408-284-2812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-31
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy