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General NPI Number Information
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NPI Number | 1407537871
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Entity Type | Organization
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Legal Business Name | UPSTAR MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 07/28/2023
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 5813 MAYFIELD RD STE 203
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-2937
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Country | US
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Telephone | 216-401-6564
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Fax |
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Provider Business Mailing Address
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Address Line | 5813 MAYFIELD RD STE 203
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-2937
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Country | US
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Telephone | 216-401-6564
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | YAHAIRA MASON
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Credential |
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Telephone | 216-401-6564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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