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STAROAKS BEHAVIORAL HOME NPI 1285284539


NPI Information

NPI: 1285284539
Provider Name: STAROAKS BEHAVIORAL HOME

Former Legal Business Name: STAROAKS BEHAVIORAL HOME CORPORATION

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
1112 E IRMA LN
PHOENIX, AZ
ZIP 85024
Phone: (713) 909-6953
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STAROAKS BEHAVIORAL HOME is a community based residential treatment facility mental illness in Phoenix, AZ. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. STAROAKS BEHAVIORAL HOME NPI is 1285284539. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Staroaks Behavioral Home Corporation.

The provider's business location address is:

1112 E IRMA LN
PHOENIX, AZ
ZIP 85024-118
Phone: (713) 909-6953

The provider's authorized official is Augustina O Joel .
The authorized official title is Administrator and has the following contact phone number (713) 909-6953.

The enumeration date for this NPI number is 9/18/2019 and was last updated on 5/19/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1BH5894MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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