NPIMap

Organization Active NPI

Valley Star Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Los Angeles, CA
National Provider Identifier
1912651902
Registry record updated Mar 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
VALLEY STAR BEHAVIORAL HEALTH, INC.
Practice address
12021 Wilmington Ave Ste 2B
Los Angeles, CA 90059-3019
Phone
(310) 221-6336
NPI assigned
Feb 8, 2022
Last updated
Mar 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

12021 Wilmington Ave Ste 2B
Los Angeles, CA 90059-3019

Mailing address

1501 Hughes Way Ste 150
Long Beach, CA 90810-1878
Phone (310) 221-6336

Other names 1

  • Valley Star MLK Behavioral Health Center CRTP Other name

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

Locations

12021 Wilmington Ave
Ste 2B
Los Angeles, CA 90059
Phone (213) 222-1681

1680 E 120th St
Ste 2B
Los Angeles, CA 90059

Practitioners & affiliated clinicians

Practitioners 4

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": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1912651902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HUGHES WAY STE 150",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908101878",
            "telephone_number": "310-221-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12021 WILMINGTON AVE STE 2B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900593019",
            "telephone_number": "310-221-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY STAR BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "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": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley Star MLK Behavioral Health Center CRTP",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Valley Star MLK Behavioral Health Center CRTP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.