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NPI 1134039910

NPI 1134039910 : NORTHSTAR BEHAVIORAL HEALTH SERVICES, LLC : PALM BEACH GARDENS, FL

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General NPI Number Information
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    NPI Number           |    1134039910
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    Entity Type          |    Organization 
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    Legal Business Name  |    NORTHSTAR BEHAVIORAL HEALTH SERVICES, LLC 
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Dates
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    Enumeration Date     |    09/11/2026
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    Last Update Date     |    09/11/2026
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Provider Practice Location Address
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    Address Line         |    4750 E PARK DR STE 110 
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    City                 |    PALM BEACH GARDENS
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    State                |    FL
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    Zip                  |    33410-4333
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    Country              |    US
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    Telephone            |    561-781-9400
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    420 US HIGHWAY 1 STE 15 
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    City                 |    NORTH PALM BEACH
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    State                |    FL
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    Zip                  |    33408-5599
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    Country              |    US
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    Telephone            |    561-781-9400
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR OF FINANCE
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    Name                 |     KIM  WADE 
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    Credential           |    
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    Telephone            |    561-308-8441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0855X
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    Taxonomy Name        |    Adolescent and Children Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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