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NPI Code Detail

MEDICARE: STAR VIEW BEHAVIORAL HEALTH, INC.

MEDICARE: STAR VIEW BEHAVIORAL HEALTH, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2261QM0855XAdolescent and Children Mental Health Clinic/CenterCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17367OTHERCASTATE DMH PROVIDER NUMBER
2BU-20007250OTHERCITY OF LONG BEACH BIZLIC

General Provider Information

NPI Number : 1427136621
Entity Type Code : Organization
Provider Name (Legal Business Name) : STAR VIEW BEHAVIORAL HEALTH, INC.
Provider Business Mailing Address
First Line : 4500 E. PACIFIC COAST HIGHWAY
Second Line : SUITE 100
City : LONG BEACH
State : CA
Zip : 90804-3233
Country : US
Telephone Number : 562-344-1140
Fax Number : 562-685-0735
Provider Business Practice Location Address
First Line : 4500 E. PACIFIC COAST HIGHWAY
Second Line : SUITE 100
City : LONG BEACH
State : CA
Zip : 90804-3233
Country : US
Telephone Number : 562-344-1140
Fax Number : 562-685-0735
Authorized Official
Title or Position : PRESIDENT AND CHIEF EXECUTIVE OFFIC
Name : KENT DUNLAP
Credential :
Telephone Number : 310-221-6336
Provider Enumeration Date : 11/02/2006
Last Update Date : 12/23/2024

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