Valley Star Behavioral Health, Inc.
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · San Bernardino, CA
NPI 1851637151 · NPPES record last updated Dec 7, 2018
Key facts
- NPI
- 1851637151
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- Legal business name
- VALLEY STAR BEHAVIORAL HEALTH, INC.
- Practice address
- 780 E Gilbert St
San Bernardino, CA 92415-1003 - Phone
- (909) 763-4760
- NPI assigned
- Dec 14, 2012
- Organization subpart
- No
Authorized official
- Name
- Kent Dunlap
- Title
- President and Chief Executive Offic
- Phone
- (310) 221-6336
Other NPIs on the same Medicare enrollment 13
Corporate family (same tax ID) 20
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210630000796 | CA | Part B Supplier - Clinic/Group Practice | 8628479441 |
Receives reassigned benefits from 2 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Downey, CA; Yucca Valley, CA; Victorville, CA; San Bernardino, CA; Los Angeles, CA; Joshua Tree, CA; Sylmar, CA |
National Provider Directory
- Tax ID family
- Valley Star Behavioral Health Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Yes |
Addresses
Primary practice location
780 E Gilbert St
San Bernardino, CA 92415-1003
Mailing address
1501 Hughes Way
Suite 150
Long Beach, CA 90810-1876
Phone (310) 221-6336
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2016029 | Other | CA | DEPARTMENT OF MENTAL HEALTH |
Other names
- Valley Star CRT - 'The Stay'
Other providers in San Bernardino, CA
- Ayisha Vallega
- Valley Physical Therapy
- Valley Star Behavioral Health, Inc.
- Valley Star Behavioral Health, Inc.
- Valley Star Behavioral Health, Inc.
- Valley Star CRT - 'the Stay'
- Valor Hospice & Palliative Care, Inc.
- Cindy Yvette Valverde
- Oriana Van Dyke
- Ellie Van Heerde
All providers in San Bernardino, CA · Mental Illness Community Based Residential Treatment Facility in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.