NPIMap

Organization Active NPI

Stanley Street Treatment and Resources, Inc

Doing business as Sstar Integrated Health Services Center

  • Federally Qualified Health Center (FQHC)
  • Fall River, MA
National Provider Identifier
1932838513
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
STANLEY STREET TREATMENT AND RESOURCES, INC
Doing business as
Sstar Integrated Health Services Center
Practice address
75 Weaver St
Fall River, MA 02720-1309
Phone
(508) 675-1054
Fax
(508) 324-7777
NPI assigned
Jun 8, 2022
Last updated
Jun 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Authorized official

Name
Sherry Ann EllisNPI 1780742064
Title
Ceo
Phone
(085) 324-3550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

75 Weaver St
Fall River, MA 02720-1309

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
4379OtherMADEPARTMENT OF PUBLIC HEALTH

Other names 1

  • SSTAR INTEGRATED HEALTH SERVICES CENTER 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
O20240220002215 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 1932838513. Details of each certification follow.

Federally qualified health center certification: CCN 221006

Legal name
STANLEY STREET TREATMENT AND RESOURCES, INC
Doing business as
SSTAR INTEGRATED HEALTH SERVICES CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 12, 2024
Last certification
Jan 12, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 19, 1977 in MA
Enrollment address
75 Weaver St
Fall River, MA 27201309

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.

Locations

386 Stanley St
Fall River, MA 02720
Phone (508) 324-3550

75 Weaver St
Fall River, MA 02720
Phone (508) 235-5010

Ownership & related parties

All disclosed owners & managing parties 24

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
Joan Bertrand Individual Corporate OfficerChief Human Resources Officer Sep 9, 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
Candice Rock Individual W-2 Managing EmployeeDirector of Nursing Oct 23, 2023
Thomas Hoye Individual Corporate DirectorBoard of Directors Nov 15, 2018
Donald E Duger Individual Corporate OfficerChief Operating Officer Dec 18, 2023
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
Joseph Porreca Individual Corporate OfficerChief Information Officer Apr 25, 2022
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
Genie Lark Bailey Individual Corporate OfficerChief Behavioral Health Officer Jan 1, 2022
James Clarkin Individual Corporate DirectorBoard of Directors Nov 23, 2010
Veronica Joan King Individual Corporate DirectorBoard of Directors Nov 23, 2017
Julie Shaw Individual Corporate OfficerChief Financial Officer May 22, 2023

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 48

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.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1932838513",
    "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": "75 WEAVER ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201309",
            "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": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "085-324-3550"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "4379",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSTAR INTEGRATED HEALTH SERVICES CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.