Organization
STARKS HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY DUJUAN STARKS (PROGRAM ADMINISTRATOR)
(520) 304-6681
Entity
Organization
Contact information
Practice address
2873 E LUCCA LN, VAIL, AZ 85641-9712
(520) 762-9836
Mailing address
2873 E LUCCA LN, VAIL, AZ 85641-9712
(520) 762-9836
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH4675
AZ
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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