1205969797 NPI number — STIRLING ACADEMY, INC.

Table of content: (NPI 1205969797)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205969797 NPI number — STIRLING ACADEMY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STIRLING ACADEMY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
STIRLING BEHAVIORAL HEALTH INSTITUTE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205969797
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6931 VAN NUYS BLVD STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VAN NUYS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91405-3980
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-376-0134
Provider Business Mailing Address Fax Number:
818-376-1437

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6931 VAN NUYS BLVD.
Provider Second Line Business Practice Location Address:
#101-102
Provider Business Practice Location Address City Name:
VAN NUYS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-376-0134
Provider Business Practice Location Address Fax Number:
818-376-1437
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BROOMAND
Authorized Official First Name:
CAROLINE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
818-376-0134

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  PSY6925 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261Q00000X , with the licence number: PSB31242 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7481A . This is a "LA COUNTY MENTAL HEALTH" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com