Provider Demographics
NPI:1518326826
Name:STARS HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:STARS HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ITAKPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-473-8101
Mailing Address - Street 1:1045 TAYLOR AVE STE 108A
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-8336
Mailing Address - Country:US
Mailing Address - Phone:443-473-8101
Mailing Address - Fax:
Practice Address - Street 1:1045 TAYLOR AVE STE 108A
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-8336
Practice Address - Country:US
Practice Address - Phone:443-473-8101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6720101YM0800X
MDLC3560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty