| NPI | 1972660231 |
|---|---|
| Other Name | CSTAR-ADULT - JC |
| Entity Type | Organization |
| Authorized Contact | MELVIN FETTER VP 660-885-8131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |