STARSHINE TREATMENT CENTER (NPI# 1457803645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457803645 |
| Entity Type | Organization |
| Organization Name | STARSHINE TREATMENT CENTER |
| Practice Address |
731 E 40th St San Bernardino CA 92404-1448 |
| Mailing Address |
460 S Stoddard Ave Ste 1&3 San Bernardino CA 92401-2001 |
| Practice Telephone | 9098814915 |
| Practice Fax Number | 9098821282 |
| Mailing Telephone | 9098827978 |
| Mailing Fax Number | 9098821282 |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2018-03-28 |
| Authorized Official Name | DR. JAMES PACE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9098827978 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 360910260 | CA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295279115 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1255 E Highland Ave Ste 217, San Bernardino, CA 92404-4653 | 2016-12-12 |
| 1235671108 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1584 Buckeye St, Highland, CA 92346-3296 | 2016-11-09 |
| 1821540014 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 2965 Garden Dr, San Bernardino, CA 92404-2525 | 2016-11-04 |
| 1770025926 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1004 E Lynwood Dr, San Bernardino, CA 92404-2545 | 2016-11-04 |
| Street Address |
731 E 40TH ST |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92404-1448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740849363 | Danniella Alexandra Murillo | Physician Assistant | 2101 North Waterman Ave, San Bernardino, CA 92404 | 2019-06-07 |
| 1902377484 | Shauntel Renee Nelson | Student in an Organized Health Care Education/Training Program | 1481 N. Windsor Dr., San Bernardino, CA 92404 | 2018-12-10 |
| 1487123584 | Garrett M Grigg | Licensed Psychiatric Technician | 1481 N Windsor Dr, San Bernardino, CA 92404 | 2018-11-19 |
| 1881163434 | James Dean Anders | Counselor | 1481 Windsor Drive, San Bernardino, CA 92404 | 2018-11-13 |
| 1043703564 | Samantha Makpaiboonvatana | Optometrist | 1909 N Waterman Ave Ste 3, San Bernardino, CA 92404 | 2018-06-09 |
| 1861981623 | Christopher Windham | Behavior Technician | 2460 Fremontia Dr, San Bernardino, CA 92404 | 2018-05-08 |
| 1891145041 | Cynthia Lusy Gastelum | Marriage & Family Therapist | 1885 E Lynwood Dr Rm Se3, San Bernardino, CA 92404 | 2016-06-20 |
| 1336598259 | Foundation Enterprises LLC | Non-emergency Medical Transport (VAN) | 1663 Date Pl., #30390, San Bernardino, CA 92404 | 2016-06-10 |
| 1881042877 | Helen Ann Thompson | Speech-Language Pathologist | 1311 E. State St., San Bernardo, CA 92404 | 2016-05-31 |
| 1366839938 | Lanecia Richardson | Counselor | 135 Paul Drive, San Rafeal, CA 92404 | 2015-04-22 |
| Find all providers in zip 92404 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134693153 | Citadel Community Care Facilities | Residential Treatment Facility, Emotionally Disturbed Children | 568 N Mountain View Ave, San Bernardino, CA 92401-1231 | 2019-01-12 |
| 1295279115 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1255 E Highland Ave Ste 217, San Bernardino, CA 92404-4653 | 2016-12-12 |
| 1821540014 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 2965 Garden Dr, San Bernardino, CA 92404-2525 | 2016-11-04 |
| 1770025926 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 1004 E Lynwood Dr, San Bernardino, CA 92404-2545 | 2016-11-04 |
| 1770032534 | Lifeskills Development | Residential Treatment Facility, Emotionally Disturbed Children | 6095 Shepherd Dr, San Bernardino, CA 92407-2251 | 2016-09-22 |
| 1811343445 | Starshine Treatment Center, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 460 S Stoddard Ave Ste 1&3, San Bernardino, CA 92401-2001 | 2016-05-12 |
| 1003368655 | Starshine Treatment Center Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1255 E Highland Ave, Ste 215, San Bernardino, CA 92404-6804 | 2016-10-31 |
| 1437499142 | Rey Vargas | Residential Treatment Facility, Emotionally Disturbed Children | 1053 N D St, San Bernardino, CA 92410-3521 | 2013-02-18 |
| 1134467665 | Latoya Jackson | Residential Treatment Facility, Emotionally Disturbed Children | 1053 N D St, San Bernardino, CA 92410-3521 | 2013-01-17 |
| 1366786782 | Victor Treatment Centers, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1053 N D St, San Bernardino, CA 92410-3521 | 2012-11-26 |
| Find all providers in SAN BERNARDINO | ||||
| City | SAN BERNARDINO |
| Zip Code | 92404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.