| Star Central | |
|
2144 E Roosevelt St Phoenix AZ 85006-3830 | |
| (602) 685-1295 | |
| (602) 685-1298 |
| Full Name | Star Central |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2144 E Roosevelt St, Phoenix, Arizona |
| Authorized Official Name and Position | Colleen D Craig (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6022310071 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Star Central Po Box 61358 Phoenix AZ 85082-1358 Ph: (602) 231-0071 | Star Central 2144 E Roosevelt St Phoenix AZ 85006-3830 Ph: (602) 685-1295 |
| NPI Number | 1417039686 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Medicare PECOS PAC ID | 9335537976 |
|---|---|
| Medicare Enrollment ID | O20211101000744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417039686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CSA06ADHS0058 (Arizona) | Primary |
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