Healthcare Provider Details

I. General information

NPI: 1285843342
Provider Name (Legal Business Name): STARR PSYCHIATRIC CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 PEARL ST
BROCKTON MA
02301-2825
US

IV. Provider business mailing address

22 TRACEY LN
SHARON MA
02067-3132
US

V. Phone/Fax

Practice location:
  • Phone: 508-580-2211
  • Fax: 508-427-1772
Mailing address:
  • Phone: 508-580-2211
  • Fax: 508-427-1772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number152784
License Number StateMA

VIII. Authorized Official

Name: DR. DAVID STARR
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 508-580-2211