Provider Demographics
NPI:1235938036
Name:RJ STARLIGHT HOME CORPORATION
Entity type:Organization
Organization Name:RJ STARLIGHT HOME CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOMOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-250-1473
Mailing Address - Street 1:24 HUCKLEBERRY CT
Mailing Address - Street 2:
Mailing Address - City:BRISBANE
Mailing Address - State:CA
Mailing Address - Zip Code:94005-1264
Mailing Address - Country:US
Mailing Address - Phone:415-250-1473
Mailing Address - Fax:415-648-2280
Practice Address - Street 1:2680 BRYANT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4224
Practice Address - Country:US
Practice Address - Phone:415-250-1473
Practice Address - Fax:415-648-2280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility