STARS BEHAVIORAL HEALTH GROUP, INC. (NPI# 1215551890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215551890 |
| Entity Type | Organization |
| Organization Name | STARS BEHAVIORAL HEALTH GROUP, INC. |
| Other Organization Name | AMHS COASTAL STAR CRISIS RESIDENTIAL CENTRAL |
| Practice Address |
401 S Tustin St Bldg D Orange CA 92866-2550 |
| Mailing Address |
1501 Hughes Way Ste 150 Long Beach CA 90810-1878 |
| Practice Telephone | 7142893936 |
| Mailing Telephone | 3102216336 |
| Enumeration Date | 2020-05-30 |
| Last Update Date | 2020-09-26 |
| Authorized Official Name | KENT DUNLAP (PRESIDENT AND CHIEF EXECUTIVE OFFIC) |
| Authorized Official Telephone | 3102216336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| AMHS Coastal Star Crisis Residential Central | Doing Business As Name - Organization |
| Coast Star Crisis Residential Central | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | STARS BEHAVIORAL HEALTH GROUP, INC | 17571 Bothell Way Ne, Lake Forest Park, WA 98155 |
| New York State Corporations | STARS BEHAVIORAL HEALTH GROUP, INC. | 7677 Oakport Street Suite 1010, Oakland, Ca 94621 |
| Street Address |
401 S TUSTIN ST BLDG D |
| City | ORANGE |
| State | CA |
| Zip Code | 92866-2550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861641813 | Diana Miltenburg | Social Worker | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2008-09-15 |
| 1386258614 | Adrienne Michaela Burr | Social Worker | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2020-09-03 |
| 1073126165 | Alicia Beatriz Medina | Marriage & Family Therapist | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2020-08-28 |
| 1952926719 | Victoria Larissa Romero | Counselor | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2020-06-08 |
| 1457976235 | Viviana Mejia | Counselor | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2020-06-08 |
| 1790304434 | Erin Allison Pruitt | Marriage & Family Therapist | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2020-04-13 |
| 1891329256 | Rolando Ramirez Jr. | Licensed Psychiatric Technician | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2020-02-25 |
| 1417597915 | Michael Akande Abanise | Licensed Psychiatric Technician | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2020-01-13 |
| 1861039448 | Angela Marie Stephens | Counselor | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2019-12-03 |
| 1154967784 | Leonard Hartiz Coaston | Counselor | 401 S Tustin St Bldg D, Orange, CA 92866-2550 | 2019-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1477114122 | Beverley P Brownell | Nurse Practitioner | 1215 E. Chapman Avenue, Orange, CA 92866 | 2019-06-24 |
| 1528539442 | Brian Chau | Pharmacist | 1538 E. Chapman Ave, Orange, CA 92866 | 2018-12-17 |
| 1891214599 | Nancy Lee Mcdonald | Registered Nurse | 700 Sout Tustin, Orange, CA 92866 | 2017-09-13 |
| 1962932541 | Hao Phu Nguyen | Counselor | 401 S. Tustin Street, Building D, Orange, CA 92866 | 2017-06-15 |
| 1932567377 | Lori Lynn Hughes | Psychologist | 734 E. Chapman Ave., Suite 734, Orange, CA 92866 | 2016-01-30 |
| 1417291360 | Lori Ann Bartczak | Speech-Language Pathologist | 393 S. Tustin St., Orange, CA 92866 | 2012-11-15 |
| 1497046064 | Pacific Shore Surgery Center | Clinic/Center | 302 W. Laveta Ave, Suite 100, Orange, CA 92866 | 2011-04-29 |
| 1871805127 | Spring Medley Peavy | Nurse Practitioner | 1040 E. Chapman Ave, Orange, CA 92866 | 2010-07-01 |
| 1790956084 | Kevin Robert Franks | Dentist | 532 E Chapman Ave, Orange, CA 92866 | 2008-03-14 |
| Find all providers in zip 92866 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407056880 | Lily Thanh Hoang | Community Based Residential Treatment Facility, Mental Illness | 401 S Tustin St, Bldg. D, Orange, CA 92866-2550 | 2007-07-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.