Healthcare Provider Details

I. General information

NPI: 1700709870
Provider Name (Legal Business Name): NORTH STAR YOUTH ACADEMY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2545 PETZINGER RD
COLUMBUS OH
43209-3498
US

IV. Provider business mailing address

3314 NOE BIXBY RD STE 103
COLUMBUS OH
43232-6065
US

V. Phone/Fax

Practice location:
  • Phone: 614-586-3009
  • Fax:
Mailing address:
  • Phone: 614-586-3009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: HAMZA CRENSHAW
Title or Position: OWNER/CASE MANAGER
Credential:
Phone: 614-586-3009