Starlight Behavioral Health LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

STARLIGHT BEHAVIORAL HEALTH LLC

Practice address

5668 N 109TH Ave
Phoenix, AZ 85037-5768

Phone

(520) 445-5832

NPI assigned

Jun 1, 2022

Last updated

Jun 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Anicet Ndagijimana

Title

Owner

Phone

(520) 445-5832

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1568101244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5668 N 109TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5668 N 109TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375768",
            "telephone_number": "520-445-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARLIGHT BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "NDAGIJIMANA",
        "authorized_official_first_name": "ANICET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-445-5832"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZDHS",
            "identifier": "BH7579",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "STARLIGHTBHRF@GMAIL.COM",
            "affiliation": "N",
            "address_1": "5668 N 109th Ave",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850375768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.