NPIMap

Organization Active NPI

Subacute Treatment for Adolescent Rehabilitation Services, Inc.

Doing business as STARS Community Services

  • Community/Behavioral Health Agency
  • San Leandro, CA
National Provider Identifier
1336476274
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SUBACUTE TREATMENT FOR ADOLESCENT REHABILITATION SERVICES, INC.
Doing business as
STARS Community Services
Practice address
15555 E 14TH St
Ste 317
San Leandro, CA 94578-1900
Phone
(510) 635-9705
NPI assigned
Nov 13, 2009
Last updated
Dec 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Authorized official

Name
Kent Dunlap
Title
President and Chief Executive Offic
Phone
(310) 221-6336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

15555 E 14TH St
Ste 317
San Leandro, CA 94578-1900

Mailing address

400 Estudillo Ave Ste 100
San Leandro, CA 94577-4962
Phone (510) 635-9705

Other identifiers 1

IdentifierTypeStateIssuer
38125OtherCITY OF SAN LEANDRO BUISNESS LICENSE

Other names 1

  • STARS Community Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110120001103 CA Part B Supplier - Clinic/Group Practice 0547449621 Receives reassigned benefits from 2 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Leandro, CA

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1336476274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ESTUDILLO AVE STE 100",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774962",
            "telephone_number": "510-635-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15555 E 14TH ST",
            "address_2": "STE 317",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781900",
            "telephone_number": "510-635-9705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBACUTE TREATMENT FOR ADOLESCENT REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "DUNLAP",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "PRESIDENT AND CHIEF EXECUTIVE OFFIC",
        "authorized_official_telephone_number": "310-221-6336"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITY OF SAN LEANDRO BUISNESS LICENSE",
            "identifier": "38125",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STARS Community Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STARS Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.