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General NPI Number Information
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NPI Number | 1801555362
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Entity Type | Organization
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Legal Business Name | NORTHSTAR SERVICES
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Dates
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Enumeration Date | 12/13/2021
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 1202 E 14TH ST
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City | WAYNE
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State | NE
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Zip | 68787-1247
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Country | US
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Telephone | 402-375-2881
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 280
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City | WAYNE
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State | NE
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Zip | 68787-0280
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Country | US
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Telephone | 402-750-7018
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Fax | 402-375-2703
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Authorized Official
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Title or Position | ACCOUNTING SUPPORT SPECIALIST
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Name | MS. TRACEY M NIEMANN
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Credential |
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Telephone | 402-750-7018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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