Organization
STARRVISTA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM CHUCK JACKSON (EXECUTIVE DIRECTOR)
(313) 387-1238
Entity
Organization
Contact information
Practice address
22390 W 7 MILE RD, DETROIT, MI 48219-1849
(313) 387-6000
(313) 387-0760
Mailing address
22390 W 7 MILE RD, DETROIT, MI 48219-1849
(313) 387-6000
(313) 387-0760
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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