Provider Demographics
| NPI: | 1578298550 |
|---|---|
| Name: | UPSTAR MENTAL HEALTH SERVICES LLC |
| Entity type: | Organization |
| Organization Name: | UPSTAR MENTAL HEALTH SERVICES LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | YAHAIRA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | MASON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 216-971-1023 |
| Mailing Address - Street 1: | 5813 MAYFIELD RD STE 203 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MAYFIELD HEIGHTS |
| Mailing Address - State: | OH |
| Mailing Address - Zip Code: | 44124-2937 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 216-401-6564 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 5813 MAYFIELD RD STE 203 |
| Practice Address - Street 2: | |
| Practice Address - City: | MAYFIELD HEIGHTS |
| Practice Address - State: | OH |
| Practice Address - Zip Code: | 44124-2937 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 216-401-6564 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2022-07-22 |
| Last Update Date: | 2024-02-19 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
| No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QP2400X | Ambulatory Health Care Facilities | Clinic/Center | Prison Health |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
| No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | |
| No | 385H00000X | Respite Care Facility | Respite Care |
