Provider Demographics
NPI:1205077930
Name:STARKE INSTITUTE LLC
Entity type:Organization
Organization Name:STARKE INSTITUTE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ZANE
Authorized Official - Middle Name:BARAK
Authorized Official - Last Name:STARKEWOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-671-4584
Mailing Address - Street 1:68247 CALLE AZTECA
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-6424
Mailing Address - Country:US
Mailing Address - Phone:760-671-4584
Mailing Address - Fax:760-671-4584
Practice Address - Street 1:68247 CALLE AZTECA
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6424
Practice Address - Country:US
Practice Address - Phone:760-671-4584
Practice Address - Fax:760-671-4584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility