VALLEY STAR MLK BEHAVIORAL HEALTH CENTER CRTP
NPI 1912651902
Community/Behavioral Health in Los Angeles, CA
NPI Status: Active since February 08, 2022
Contact Information
12021 WILMINGTON AVE STE 2B
LOS ANGELES, CA
ZIP 90059
Phone: (310) 221-6336
- Organization
- Community/Behavioral Health
- CLIA Number: 05D2276395
- CLIA Cert. Type: Other - CRISIS RESIDENTIAL TREATM
- CLIA Exp. Date: 02-07-2027
About VALLEY STAR MLK BEHAVIORAL HEALTH CENTER CRTP
This page provides the complete NPI Profile along with additional information for Valley Star Mlk Behavioral Health Center Crtp, a provider established in Los Angeles, California operating as a Community/behavioral Health. The healthcare provider is registered in the NPI registry with number 1912651902 assigned on February 2022. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's other name is Valley Star Mlk Behavioral Health Center Crtp. The authorized official of this NPI record is Kent Dunlap (President And Chief Executive Offic)
- NPI
- 1912651902
- Provider Legal Name
- VALLEY STAR BEHAVIORAL HEALTH, INC.
- Other Organization Name
- VALLEY STAR MLK BEHAVIORAL HEALTH CENTER CRTP
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059
- Location Phone
- (310) 221-6336
- Mailing Address
- 1501 HUGHES WAY STE 150 LONG BEACH, CA 90810
- Mailing Phone
- (310) 221-6336
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-08-2022
- Last Update Date
- 03-04-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community/Behavioral Health
- Taxonomy Code
- 251S00000X
- Type
- Agencies
- Taxonomy Description
- A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2276395
- Facility Type
- Other - CRISIS RESIDENTIAL TREATM
- Certificate Effective Date
- February 08, 2025
- Certificate Expiration Date
- February 07, 2027
- Laboratory Director
- WEIMING CHU
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Valley Star Mlk Behavioral Health Center Crtp to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 9 | 1 | 2 | 6 | 5 | 1 | 9 | 0 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 9 | 2 | 2 | 12 | 5 | 2 | 9 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 9 + 2 + 2 + 1 + 2 + 5 + 2 + 9 + 0 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1912651902 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1245748854 | ETHAN J HOVEST LCDCIII Individual | Rehabilitation Practitioner | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1528770310 | BIANCA HERNANDEZ Individual | Case Manager/Care Coordinator | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1144934563 | EBONY ANDERSON Individual | Licensed Vocational Nurse | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1750047908 | SAMANTHA NICOLE AVILA Individual | Licensed Vocational Nurse | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1205540879 | TIA SIMONE MCCLOUD Individual | Case Manager/Care Coordinator | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1578264610 | ANAIS SMITH Individual | Licensed Vocational Nurse | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1629788500 | EBONY NICOLE BRYANT Individual | Marriage & Family Therapist | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1760941512 | LUDIM SISMAI BALTAZAR Individual | Case Manager/Care Coordinator | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1790470748 | BREYA HARDEN Individual | Rehabilitation Practitioner | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1881320893 | FELICIA LACHELLE ECHOLS Individual | Rehabilitation Practitioner | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1902505779 | HILJIM LOPEZ BONILLA Individual | Licensed Vocational Nurse | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1629789300 | KESHAWNNA STILLWELL Individual | Case Manager/Care Coordinator | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1538305099 | CHARLES ANTHONY RICKS Individual | Community Health Worker | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1316659071 | JANET MICHELLE JIMENEZ BUSTOS Individual | Community Health Worker | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1538863238 | TRINA LOUISE WILLIAMS Individual | Community Health Worker | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1609554963 | JUSTIN JORDAN RICHARDSON Individual | Community Health Worker | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1700012481 | MR. JOSE GUTIERREZ MSW Individual | Social Worker | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1114582343 | MICHEAL HODGES Individual | Community Health Worker | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1831896125 | JASMINE JOY SAMUELS Individual | Community Health Worker | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
| 1932980588 | EBONY HARRIS LPN, LVN Individual | Licensed Vocational Nurse | 12021 WILMINGTON AVE STE 2B LOS ANGELES, CA 90059 (310) 221-6336 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912651902, enumerated in the NPI registry as an "organization" on February 08, 2022
The provider is located at 12021 Wilmington Ave Ste 2b Los Angeles, Ca 90059 and the phone number is (310) 221-6336
This medical organization specializes in Community/Behavioral Health with taxonomy code 251S00000X
The provider's CLIA number is 05D2276395 for a "other - crisis residential treatm" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on February 08, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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