Organization Active NPI

Starshine Treatment Center, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • San Bernardino, CA
National Provider Identifier
1770025926
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
366402532 Issued in CA
Legal business name
STARSHINE TREATMENT CENTER, INC
Practice address
1004 E Lynwood Dr
San Bernardino, CA 92404-2545
Phone
(909) 881-2929
Fax
(909) 882-1282
NPI assigned
Nov 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Authorized official

Name
Dr. James Pace
Title
Executive Director
Phone
(909) 882-7978

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 366402532 CA Primary

Addresses

Primary practice location

1004 E Lynwood Dr
San Bernardino, CA 92404-2545

Mailing address

460 S Stoddard Ave Ste 1&3
San Bernardino, CA 92401-2001
Phone (909) 882-7978

National Provider Directory

National Provider Directory
Tax ID family
Starshine Treatment Center Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1770025926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 S STODDARD AVE STE 1&3",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924012001",
            "telephone_number": "909-882-7978",
            "fax_number": "909-882-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 E LYNWOOD DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924042545",
            "telephone_number": "909-881-2929",
            "fax_number": "909-882-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARSHINE TREATMENT CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-882-7978",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CA",
            "license": "366402532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.