Starlight Adolescent in San Jose - Community Based Residential Treatment Facility, Mental Illness
Starlight Adolescent - NPI 1811024789
Starlight Adolescent is a Community Based Residential Treatment Facility, Mental Illness in San Jose, California. Starlight Adolescent practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Starlight Adolescent is 1811024789. The last update date is 2020-08-22.
Starlight Adolescent's current location address is 5858 Paddon Cir, San Jose, California. You can contact this provider via phone number 4086295048. The mailing address for Starlight Adolescent is 5858 Paddon Cir, San Jose, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Starlight Adolescent |
|---|---|
| Address | 5858 Paddon Cir, San Jose, California |
| Phone Number | 4086295048 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | LPT |
|---|---|
| Authorized Official Name | Oyewole Remi Victoria |
| Credentials | LPT |
| Telephone Number | 4086619236 |
NPI Number Detail
| NPI Number | 1811024789 |
|---|---|
| Provider Enumeration Date | 2007-02-27 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 5858 Paddon Cir |
|---|---|
| City | San Jose |
| State | California (CA) |
| Post Code | 951233522 |
| Phone Number | 4086295048 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
| Licence No | 32240 |
|
Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
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Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Starlight Adolescent by the Centers for Medicare & Medicaid Services?
The Starlight Adolescent has been issued the NPI (National Provider Identifier) 1811024789 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Starlight Adolescent is physically located?
The Starlight Adolescent is physically situated at the following address: 5858 Paddon Cir, San Jose, CA, 951233522.
What is the Starlight Adolescent's area of specialization and corresponding taxonomy classification?
The Starlight Adolescent's specialty field is Community Based Residential Treatment Facility, Mental Illness, and it falls under the taxonomy code 320800000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1811024789 to Starlight Adolescent?
The Starlight Adolescent received its 1811024789 assignment from the Centers for Medicare & Medicaid Services on 2007-02-27.
As of what date was the information pertaining to Starlight Adolescent, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Starlight Adolescent, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-22.