Provider Demographics
NPI:1457121915
Name:JAYSTARR HOMES 2INC.
Entity Type:Organization
Organization Name:JAYSTARR HOMES 2INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:STARLICIA
Authorized Official - Middle Name:DIANA
Authorized Official - Last Name:LEVENSHOWN-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-635-8811
Mailing Address - Street 1:13503 SAYBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44105-7019
Mailing Address - Country:US
Mailing Address - Phone:216-635-8811
Mailing Address - Fax:216-417-8405
Practice Address - Street 1:13503 SAYBROOK AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44105-7019
Practice Address - Country:US
Practice Address - Phone:216-635-8811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No385H00000XRespite Care FacilityRespite Care
No405300000XOther Service ProvidersPrevention Professional