Provider Demographics
NPI:1649507591
Name:STAR THERAPY, INC.
Entity type:Organization
Organization Name:STAR THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROXTEL
Authorized Official - Suffix:
Authorized Official - Credentials:OTD
Authorized Official - Phone:480-773-5383
Mailing Address - Street 1:1265 W FRONTIER ST
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-9084
Mailing Address - Country:US
Mailing Address - Phone:480-773-5383
Mailing Address - Fax:480-209-1494
Practice Address - Street 1:1265 W FRONTIER ST
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-9084
Practice Address - Country:US
Practice Address - Phone:480-773-5383
Practice Address - Fax:480-209-1494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-13
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3295225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty