NPIMap

Organization Active NPI

Valley Star Behavioral Health, Inc.

Doing business as Valley Star CRT - 'The Stay'

  • Mental Illness Community Based Residential Treatment Facility
  • San Bernardino, CA
National Provider Identifier
1851637151
Registry record updated Dec 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
VALLEY STAR BEHAVIORAL HEALTH, INC.
Doing business as
Valley Star CRT - 'The Stay'
Practice address
780 E Gilbert St
San Bernardino, CA 92415-1003
Phone
(909) 763-4760
NPI assigned
Dec 14, 2012
Last updated
Dec 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2018

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
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

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 names 1

  • Valley Star CRT - 'The Stay' Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Valley Star Behavioral Health Inc21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544140800000",
    "number": "1851637151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HUGHES WAY",
            "address_2": "SUITE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908101876",
            "telephone_number": "310-221-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 E GILBERT ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924151003",
            "telephone_number": "909-763-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY STAR BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2018-12-07",
        "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": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Star CRT - 'The Stay'",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 7, 2018; 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.