NPIMap

Organization Active NPI

Mindstar Residential Community

  • Assisted Living Facility (Mental Illness)
  • Brown Deer, WI
National Provider Identifier
1972154789
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
Legal business name
MINDSTAR RESIDENTIAL COMMUNITY
Practice address
5901 W Brown Deer Rd Unit 109
Brown Deer, WI 53223-2338
Phone
(414) 435-0303
Fax
(414) 206-2424
NPI assigned
Sep 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Authorized official

Name
Dr. Starlette Patterson-Biddle, PHDNPI 1689800674
Title
Executive Director
Phone
(414) 435-0303

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
Assisted Living Facility (Mental Illness) 3104A0625X Primary

Addresses

Primary practice location

5901 W Brown Deer Rd Unit 109
Brown Deer, WI 53223-2338

Mailing address

PO Box 1115
Menomonee Falls, WI 53052-1115
Phone (414) 435-0303

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1972154789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1115",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530521115",
            "telephone_number": "414-435-0303",
            "fax_number": "414-206-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W BROWN DEER RD UNIT 109",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532232338",
            "telephone_number": "414-435-0303",
            "fax_number": "414-206-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDSTAR RESIDENTIAL COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-23",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "PATTERSON-BIDDLE",
        "authorized_official_first_name": "STARLETTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "414-435-0303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brown Deer, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.