Organization
STAROAKS BEHAVIORAL HOME
Active
Other names
STAROAKS BEHAVIORAL HOME CORPORATION
Organization subpart
No
Provider details
NPI number
Authorized official
AUGUSTINA O JOEL (ADMINISTRATOR)
(713) 909-6953
Entity
Organization
Contact information
Practice address
1112 E IRMA LN, PHOENIX, AZ 85024-4118
(713) 909-6953
Mailing address
1112 E IRMA LN, PHOENIX, AZ 85024-4118
(713) 909-6953
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH5894
—
AZ
Enumeration date
09/18/2019
Last updated
05/19/2022
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