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General NPI Number Information
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NPI Number | 1033269543
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Entity Type | Organization
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Legal Business Name | VALLEY STAR BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 02/08/2017
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Provider Practice Location Address
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Address Line | 1585 SOUTH D STREET SUITE 101, 205
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3257
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Country | US
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Telephone | 909-388-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 1585 SOUTH D STREET SUITE 101, 205
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-3257
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Country | US
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Telephone | 909-388-2222
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CHIEF EXECUTIVE OFFIC
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Name | KENT DUNLAP
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Credential |
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Telephone | 310-221-6336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | CA
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