Provider Demographics
NPI:1801668033
Name:STAR MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:STAR MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-202-7382
Mailing Address - Street 1:2817 ANTHONY LN S STE 202
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-2490
Mailing Address - Country:US
Mailing Address - Phone:612-202-7382
Mailing Address - Fax:
Practice Address - Street 1:2817 ANTHONY LN S STE 202
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-2490
Practice Address - Country:US
Practice Address - Phone:612-202-7382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health