| Organization Name: | STARKE BEHAVIORAL HEALTH ASSOCIATION INC |
| NPI Number: | 1427404433 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAWRENCE C STARKE (EXECUTIVE DIRECTOR) |
| Mailing Address: | 120 W Broad St Blackstone |
| State: | VA US |
| Postal Code: | 238241710 |
| Phone Number: | 4342921104 |
| Fax Number: | 4342921134 |
| NPI Enumeration Date: | 05/09/2016 |
| NPI Last Update Date: | 05/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701003843 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |