Future Stars Youth Services

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

FUTURE STARS YOUTH SERVICES

Practice address

2145 Nice Ave
Mentone, CA 92359-9643

Phone

(909) 810-1481

NPI assigned

May 28, 2022

Organization subpart

No

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

Authorized official

Name

Danette Seay

Title

Program Director

Phone

(951) 453-6979

Specialties & licenses 1

Addresses

Tax ID family

Future Stars Youth Services2 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.

• Future Stars Youth Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Calimesa, CA
  • NPI 1689352809
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tabitha Lopez, LPCC

  • Professional Counselor
  • Mentone, CA
  • NPI 1427524875
  NPD
• Ronnie Lusk

  • Rehabilitation Practitioner
  • Mentone, CA
  • NPI 1508102658
  NPD

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

{
    "created_epoch": "1653696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1104565167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 981",
            "city": "CALIMESA",
            "state": "CA",
            "postal_code": "923200981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 NICE AVE",
            "city": "MENTONE",
            "state": "CA",
            "postal_code": "923599643",
            "telephone_number": "909-810-1481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUTURE STARS YOUTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-28",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "SEAY",
        "authorized_official_first_name": "DANETTE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "951-453-6979"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Terry Crocker
• Maria Rosario Cruz Heredia, AMFT
• Mohamed M Elhanafy, RRT-RCP
• Lara Elijah, DDS
• Starr Lynette Fox, PMHNP-BC
• Mishell Lynne Gama
• Jessamie Jean Garvin
• Christy Hart
• Healthcare Innovations Network, Inc
• Elizabeth An Hess

• All providers in Mentone, CA
• Emotionally Disturbed Childrens' Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.