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General NPI Number Information
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NPI Number | 1558007005
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Entity Type | Organization
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Legal Business Name | NORTH STAR RECOVERY PLLC
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 19590 W SAN MIGUEL AVE
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-5422
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Country | US
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Telephone | 623-377-0825
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Fax |
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Provider Business Mailing Address
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Address Line | 19590 W SAN MIGUEL AVE
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-5422
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DNP/OWNER
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Name | WILLIAM FOX
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Credential | DNP
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Telephone | 623-377-0825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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