Star Alliance Support Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

STAR ALLIANCE SUPPORT SERVICES

Practice address

615 Cutler Ave
Maple Shade, NJ 08052-2914

Phone

(609) 922-9061

Fax

(856) 382-7926

NPI assigned

Nov 7, 2022

Organization subpart

No

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

Authorized official

Name

Miss Priscilla Yayra Klutse

Title

Administrator

Phone

(609) 922-9061

Specialties & licenses 5

Addresses

Other names 1

• STAR ALLIANCE SUPPORT SERVICES Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1144938499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CUTLER AVE",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080522914",
            "telephone_number": "609-922-9061",
            "fax_number": "856-382-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 CUTLER AVE",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080522914",
            "telephone_number": "609-922-9061",
            "fax_number": "856-382-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR ALLIANCE SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-07",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-06",
        "status": "A",
        "authorized_official_last_name": "KLUTSE",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_middle_name": "YAYRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "609-922-9061",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@starsupports.org",
            "affiliation": "N",
            "address_1": "615 Cutler Ave",
            "city": "Maple Shade",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080522914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "STAR ALLIANCE SUPPORT SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maple Shade, NJ
• Providers in Maple Shade, NJ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; 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.