Provider Demographics
NPI:1265447015
Name:STARLITE RECOVERY CENTER, LLC
Entity Type:Organization
Organization Name:STARLITE RECOVERY CENTER, LLC
Other - Org Name:STARLITE RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT & SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-861-6000
Mailing Address - Street 1:PO BOX 317
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:TX
Mailing Address - Zip Code:78010-0317
Mailing Address - Country:US
Mailing Address - Phone:830-634-2212
Mailing Address - Fax:830-634-2532
Practice Address - Street 1:230 MESA VERDE DRIVE EAST
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:TX
Practice Address - Zip Code:78010
Practice Address - Country:US
Practice Address - Phone:830-634-2212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4428-4429OtherSUBSTANCE ABUSE TREATMENT FACILITY LICENSE - ADULT OUTPATIENT
TX4428-4431OtherSUBSTANCE ABUSE TREATMENT FACILITY LICENSE-INTENSIVE RESIDENTIAL
TX4428-4432OtherSUBSTANCE ABUSE TREATMENT FACILITY LICENSE-INTENSIVE RESIDENTIAL
TX4428-4433OtherSUBSTANCE ABUSE TREATMENT FACILITY LICENSE-IR/OP/DETOX-ADOLESCENT
TX4428-4430OtherSUBSTANCE ABUSE TREATMENT FACILITY LICENSE-IR/OP/RESIDENT