Provider Demographics
NPI:1891493508
Name:DAYSTAR BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:DAYSTAR BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:SAJEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMADE-NEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-590-2016
Mailing Address - Street 1:1132 DREXEL ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1132 DREXEL ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1106
Practice Address - Country:US
Practice Address - Phone:313-590-2016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty