Stargate Behavioral Health Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

STARGATE BEHAVIORAL HEALTH SERVICES LLC

Practice address

1924 W Alta Vista Rd
Phoenix, AZ 85041-5443

Phone

(901) 652-8154

NPI assigned

Apr 3, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sekou A Donzo

Title

Ceo

Phone

(216) 630-9350

Specialties & licenses 1

Addresses

Tax ID family

Stargate Behavioral Health Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Stargate Behavioral Health Services LLC

  • Community/Behavioral Health Agency
  • Glendale, AZ
  • NPI 1104413863
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1063974533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 W ALTA VISTA RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415443",
            "telephone_number": "901-652-8154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 W ALTA VISTA RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850415443",
            "telephone_number": "901-652-8154"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7346 N 72nd Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853031602",
            "country_code": "US",
            "telephone_number": "216-630-9350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STARGATE BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "DONZO",
        "authorized_official_first_name": "SEKOU",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-630-9350"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ellyn Celia Starikoff
• Larry D Stark, DO
• Thomas Wheeler Stark, MD
• Hannah Elizabeth Starke, MD
• Karen A Starkey, M.D.

• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.