NPIMap

Organization Active NPI

Staroaks Behavioral Home

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
National Provider Identifier
1285284539
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
STAROAKS BEHAVIORAL HOME
Practice address
1112 E Irma LN
Phoenix, AZ 85024-4118
Phone
(713) 909-6953
NPI assigned
Sep 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Authorized official

Name
Augustina O Joel
Title
Administrator
Phone
(713) 909-6953

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

1112 E Irma LN
Phoenix, AZ 85024-4118

Mailing address

1112 E Irma LN
Phoenix, AZ 85024-4118
Phone (713) 909-6953

Other identifiers 1

IdentifierTypeStateIssuer
BH5894MedicaidAZ

Other names 1

  • STAROAKS BEHAVIORAL HOME CORPORATION Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Staroaks Behavioral Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652918400000",
    "number": "1285284539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850244118",
            "telephone_number": "713-909-6953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850244118",
            "telephone_number": "713-909-6953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAROAKS BEHAVIORAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-18",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "JOEL",
        "authorized_official_first_name": "AUGUSTINA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "713-909-6953"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BH5894",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STAROAKS BEHAVIORAL HOME CORPORATION",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.