Provider Demographics
NPI:1467706622
Name:STJ LP
Entity Type:Organization
Organization Name:STJ LP
Other - Org Name:SORRENTO IN THE DESERT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STERIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-486-2273
Mailing Address - Street 1:13959 LA MAIDA ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-1906
Mailing Address - Country:US
Mailing Address - Phone:818-486-2273
Mailing Address - Fax:818-907-8420
Practice Address - Street 1:3833 E AVENUE R12
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-2500
Practice Address - Country:US
Practice Address - Phone:661-382-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550002103320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities