Provider Demographics
NPI:1558937334
Name:STAR BEHAVIOR CONSULTANTS, LLC
Entity Type:Organization
Organization Name:STAR BEHAVIOR CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CLAUW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-484-6851
Mailing Address - Street 1:13412 W STAR DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-2705
Mailing Address - Country:US
Mailing Address - Phone:586-251-2556
Mailing Address - Fax:586-884-0699
Practice Address - Street 1:13412 W STAR DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-2705
Practice Address - Country:US
Practice Address - Phone:586-251-2556
Practice Address - Fax:586-884-0699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation