NPIMap

Organization Active NPI

Stanley Street Treatment and Resources, Inc

Doing business as SSTAR South End Services

  • Federally Qualified Health Center (FQHC)
  • Fall River, MA
National Provider Identifier
1902176449
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
1-F00000909-11-01
Legal business name
STANLEY STREET TREATMENT AND RESOURCES, INC
Doing business as
SSTAR South End Services
Practice address
1010 South Main Street
Fall River, MA 02724-2855
Phone
(508) 675-1054
Fax
(508) 324-7777
NPI assigned
Dec 30, 2011
Last updated
Jan 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Authorized official

Name
Ms. Linda Schofield, B.S.
Title
Credentialing Specialist
Phone
(508) 675-1054

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 1-F00000909-11-01 Primary

Addresses

Primary practice location

1010 South Main Street
Fall River, MA 02724-2855

Mailing address

386 Stanley St
Fall River, MA 02720-6009
Phone (508) 675-1054

Other identifiers 2

IdentifierTypeStateIssuer
4379OtherMADPH CLINIC LICENSE
22D0938610OtherCLIA LAB

Other names 1

  • SSTAR South End Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040315000103 MA Part B Supplier - Clinic/Group Practice 0244129542 Receives reassigned benefits from 39 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fall River, MA
O20120727000390 MA Part A Provider - Federally Qualified Health Center (FQHC) 0244129542 Practice locations: Fall River, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902176449. Details of each certification follow.

Federally qualified health center certification: CCN 221911

Legal name
STANLEY STREET TREATMENT AND RESOURCES, INC
Doing business as
SSTAR SOUTH END SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 17, 2012
Last certification
Jul 17, 2012
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 19, 1977 in MA
Enrollment address
1010 S Main St
Fall River, MA 27242855

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Stanley Street Treatment and Resourses6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Judnita Thompson Individual Corporate DirectorBoard of Directors Oct 31, 2011
Aimee Bronhard Individual Corporate DirectorBoard of Directors May 26, 2022
Nicholas Christ Individual Corporate DirectorBoard of Directors May 26, 2022
Theresa Hirst Individual W-2 Managing EmployeeCredentialing Manager Nov 1, 2019
Sophia Hunt Individual Corporate DirectorBoard of Directors Mar 31, 2022
Thomas Hoye Individual Corporate DirectorBoard of Directors Nov 15, 2018
Edward Lambert Individual Corporate DirectorPresident, Board of Directors Nov 15, 2018
Annmarie Sawyer Individual Corporate DirectorBoard of Directors Jan 1, 2022
Margaret Christ Individual Corporate DirectorBoard of Directors Nov 23, 2017
Paula Beaulieu Individual W-2 Managing Employee Feb 28, 2020
Bethany Cantafio Individual W-2 Managing Employee Dec 3, 2010
Betty Mullins Individual Corporate DirectorBoard of Directors Nov 15, 1998
Erin McGough Individual Corporate DirectorBoard of Directors Oct 23, 2017
Sherry a Ellis Individual Corporate OfficerChief Executive Officer Jan 1, 2022
George H Maxted Individual Corporate OfficerChief Medical Officer Jan 1, 2022
Bobby Bailey Individual Corporate DirectorBoard of Directors Mar 31, 2022
James Clarkin Individual Corporate DirectorBoard of Directors Nov 23, 2010
Veronica Joan King Individual Corporate DirectorBoard of Directors Nov 23, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1902176449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "386 STANLEY ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027206009",
            "telephone_number": "508-675-1054",
            "fax_number": "508-324-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SOUTH MAIN STREET",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027242855",
            "telephone_number": "508-675-1054",
            "fax_number": "508-324-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY STREET TREATMENT AND RESOURCES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-30",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "SCHOFIELD",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "508-675-1054",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": "1-F00000909-11-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPH CLINIC LICENSE",
            "identifier": "4379",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA LAB",
            "identifier": "22D0938610",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSTAR South End Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.