Provider Demographics
NPI:1245947969
Name:STAR COMMUNITY SUPPORT SERVICES
Entity type:Organization
Organization Name:STAR COMMUNITY SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:KYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-874-1119
Mailing Address - Street 1:106 CHESLEY DR
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1759
Mailing Address - Country:US
Mailing Address - Phone:610-874-1119
Mailing Address - Fax:610-565-3802
Practice Address - Street 1:106 CHESLEY DR
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1759
Practice Address - Country:US
Practice Address - Phone:610-874-1119
Practice Address - Fax:610-565-3801
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAR COMMUNITY SUPPORT SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-02
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health