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NPI 1578331096

NPI 1578331096 : VALLEY STAR BEHAVIORAL HEALTH, INC. : SAN BERNARDINO, CA

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General NPI Number Information
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    NPI Number           |    1578331096
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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     |    12/14/2023
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    Last Update Date     |    01/09/2025
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Provider Practice Location Address
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    Address Line         |    1738 N WATERMAN AVE STE 1&2 
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    City                 |    SAN BERNARDINO
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    State                |    CA
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    Zip                  |    92404-5131
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    Country              |    US
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    Telephone            |    909-693-3302
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1738 N WATERMAN AVE STE 1&2 
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    City                 |    SAN BERNARDINO
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    State                |    CA
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    Zip                  |    92404-5131
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    Country              |    US
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    Telephone            |    909-693-3302
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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 |    
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