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Organization

S.T.A.R.T NEURODEVELOPMENT ASSESSMENT AND TREATMENT CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KIM LAKES PHD (EXECUTIVE DIRECTOR)
(909) 891-1880
Entity
Organization

Contact information

Practice address
164 W HOSPITALITY LN STE 3, SAN BERNARDINO, CA 92408-3328
(909) 891-1880
Mailing address
13852 BLUEGRASS PL, VICTORVILLE, CA 92392-5533
(760) 245-8031

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
42378
CA

Other

Enumeration date
03/28/2007
Last updated
06/26/2008
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