Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Substance Use Disorder |
261QR0405X | |||
Substance Abuse Disorder Rehabilitation Facility |
324500000X |
| NPI # | 1316616105 |
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| LBN Legal business name | NORTHSTAR RECOVERY CENTER, LLC | ||||
| Authorized official | STEVEN WINDWARD - (PRINCIPAL) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 09/07/2021 | ||||
| Last updated | 06/03/2024 - About 2 years ago | ||||
| Identifiers |
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