Healthcare Provider Details

I. General information

NPI: 1336227537
Provider Name (Legal Business Name): STAR VIEW BEHAVIORAL HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 W OLYMPIC BLVD SUITE 600
LOS ANGELES CA
90015-3809
US

IV. Provider business mailing address

1625 W OLYMPIC BLVD SUITE 600
LOS ANGELES CA
90015-3809
US

V. Phone/Fax

Practice location:
  • Phone: 323-999-2404
  • Fax: 213-201-2954
Mailing address:
  • Phone: 323-999-2404
  • Fax: 213-201-2954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: KENT DUNLAP
Title or Position: PRESIDENT AND CHIEF EXECUTIVE OFFIC
Credential:
Phone: 310-221-6336