Provider Demographics
NPI:1144989351
Name:STARR'S WATCHFUL EYE
Entity type:Organization
Organization Name:STARR'S WATCHFUL EYE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLUPS-DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-796-1466
Mailing Address - Street 1:21350 BERG RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-6617
Mailing Address - Country:US
Mailing Address - Phone:248-796-1466
Mailing Address - Fax:248-862-5787
Practice Address - Street 1:5045 E OUTER DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-3479
Practice Address - Country:US
Practice Address - Phone:313-305-4454
Practice Address - Fax:248-862-5787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities