Provider Demographics
NPI:1033378146
Name:S.T.A.R.R. FAMILY BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:S.T.A.R.R. FAMILY BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:LOERTSCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-250-4561
Mailing Address - Street 1:10270 LA HONTON DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-0439
Mailing Address - Country:US
Mailing Address - Phone:208-250-4561
Mailing Address - Fax:208-658-1707
Practice Address - Street 1:10270 LA HONTON DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-0439
Practice Address - Country:US
Practice Address - Phone:208-250-4561
Practice Address - Fax:208-658-1707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health