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NPI 1558849141

NPI 1558849141 : VALLEY STAR BEHAVIORAL HEALTH, INC. : COLTON, CA

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General NPI Number Information
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    NPI Number           |    1558849141
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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     |    08/06/2018
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    Last Update Date     |    01/02/2026
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Provider Practice Location Address
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    Address Line         |    400 N PEPPER AVE 
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    City                 |    COLTON
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    State                |    CA
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    Zip                  |    92324-1819
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    Country              |    US
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    Telephone            |    909-580-1800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    12555 MARIPOSA RD STE J 
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    City                 |    VICTORVILLE
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    State                |    CA
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    Zip                  |    92395-6010
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    Country              |    US
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    Telephone            |    760-477-2199
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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        |    167G00000X
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    Taxonomy Name        |    Licensed Psychiatric Technician
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    License Number       |    
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    License Number State |    
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