Provider Demographics
NPI:1356698559
Name:STARR (SOBRIETY TRAINING & RECOVERY RESOURCES) INC.
Entity type:Organization
Organization Name:STARR (SOBRIETY TRAINING & RECOVERY RESOURCES) INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:DESRAE
Authorized Official - Middle Name:K
Authorized Official - Last Name:KAHALE
Authorized Official - Suffix:
Authorized Official - Credentials:MHC
Authorized Official - Phone:808-722-2437
Mailing Address - Street 1:111 HEKILI ST # A1603
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2800
Mailing Address - Country:US
Mailing Address - Phone:808-722-2437
Mailing Address - Fax:808-263-1920
Practice Address - Street 1:40 AULIKE ST STE 217
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2753
Practice Address - Country:US
Practice Address - Phone:808-722-2437
Practice Address - Fax:808-263-1920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1518102250Medicaid