Healthcare Provider Details

I. General information

NPI: 1003006719
Provider Name (Legal Business Name): STAR VIEW CFS (TEAMMATES)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2007
Last Update Date: 07/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 W VICTORIA ST
COMPTON CA
90220-5804
US

IV. Provider business mailing address

1055 W VICTORIA ST
COMPTON CA
90220-5804
US

V. Phone/Fax

Practice location:
  • Phone: 310-868-5379
  • Fax:
Mailing address:
  • Phone: 310-868-5379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. BATTINA LOUISE LEE
Title or Position: FACILITATOR
Credential:
Phone: 909-947-7144