Provider Demographics
NPI:1285843342
Name:STARR PSYCHIATRIC CENTER, INC.
Entity Type:Organization
Organization Name:STARR PSYCHIATRIC CENTER, INC.
Other - Org Name:STARR CLINICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-580-2211
Mailing Address - Street 1:22 TRACEY LN
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-3132
Mailing Address - Country:US
Mailing Address - Phone:508-580-2211
Mailing Address - Fax:508-427-1772
Practice Address - Street 1:529 PEARL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2825
Practice Address - Country:US
Practice Address - Phone:508-580-2211
Practice Address - Fax:508-427-1772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152784364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA500206OtherTUFTS PROVIDER NUMBER