Provider Demographics
NPI:1508224486
Name:SUBACUTE TREATMENT FOR ADOLESCENT REHABILITATION SERVICES, INC.
Entity Type:Organization
Organization Name:SUBACUTE TREATMENT FOR ADOLESCENT REHABILITATION SERVICES, INC.
Other - Org Name:STARS COMMUNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CHIEF EXECUTIVE OFFIC
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNLAP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-221-6336
Mailing Address - Street 1:400 ESTUDILLO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4962
Mailing Address - Country:US
Mailing Address - Phone:510-352-9200
Mailing Address - Fax:
Practice Address - Street 1:17115 MEEKLAND AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-1304
Practice Address - Country:US
Practice Address - Phone:510-317-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health