STARSHINE TREATMENT CENTER, INC (NPI# 1811343445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811343445 |
| Entity Type | Organization |
| Organization Name | STARSHINE TREATMENT CENTER, INC |
| Practice Address |
460 S Stoddard Ave Ste 1&3 San Bernardino CA 92401-2001 |
| Practice Telephone | 9098827978 |
| Practice Fax Number | 9098821282 |
| Mailing Telephone | 9098827978 |
| Mailing Fax Number | 9098821282 |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2018-03-06 |
| Authorized Official Name | DR. JAMES BERNARD PACE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9098827978 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 360910261 | CA | Residential Treatment Facilities |
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 360911127 | CA | Residential Treatment Facilities |
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 366402532 | CA | Residential Treatment Facilities |
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 360910260 | CA | Residential Treatment Facilities |
| Street Address |
460 S STODDARD AVE STE 1&3 |
| City | SAN BERNARDINO |
| State | CA |
| Zip Code | 92401-2001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885468 | Eagles Wings Hospice, LLC | Hospice Care, Community Based | 255 N. D Street, Suite 200-xix, San Bernardino, CA 92401 | 2020-09-09 |
| 1457831398 | Omar Torres | Case Manager/Care Coordinator | 574 N Arrowhead Ave., San Bernardino, CA 92401 | 2018-08-20 |
| 1104354539 | Llesenia Aleman | Case Manager/Care Coordinator | 597 North Arrowhead Ave, San Bernardino, CA 92401 | 2017-05-30 |
| 1669916193 | Yvonne Castro | Marriage & Family Therapist | 572 N. Arrowhead Ave., Suite 200, San Bernardino, CA 92401 | 2016-12-19 |
| 1811342132 | Maria Teresa Rodriguez Cortes | Counselor | 572 N. Arrowhead Ave. Suite 100, San Bernardino, CA 92401 | 2016-04-25 |
| 1841603339 | Kelly Michelle Cottingham | Licensed Practical Nurse | 350 W. Fifth Street, Suite 212, San Bernardino, CA 92401 | 2014-06-03 |
| 1558781245 | Desiree Inez Harris | Counselor | 572 N Arrowhead Ave #200, San Bernardino, CALIFORNIA 92401 | 2014-04-21 |
| 1194159970 | Sabrina Shrita Thakur | Marriage & Family Therapist | 572 N Arrowhead, San Bernardino, CA 92401 | 2013-08-28 |
| 1770845497 | Youths' Hope Licensed Clinical Social Worker Inc | Counselor | 255 N. D Street, Suite 400, San Bernardino, CA 92401 | 2012-06-08 |
| 1235461427 | Erin Nicole Stines | Recreation Therapist | 572 N. Arrowhead Ave. Suite 200, San Bernardino, CA 92401 | 2010-02-12 |
| Find all providers in zip 92401 | ||||
| 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 |
| 1457803645 | Starshine Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 731 E 40th St, San Bernardino, CA 92404-1448 | 2016-11-04 |
| 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 |
| 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 | 92401 |
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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.