=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831346048
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH STAR VENTURES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/19/2008
-----------------------------------------------------
Last Update Date | 08/19/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8516 N OAK TRFY SUITE D
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64155-2433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-436-6688
-----------------------------------------------------
Fax | 816-436-0988
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8516 N OAK TRFY SUITE D
-----------------------------------------------------
City | KANSAS CITY
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64155-2433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-436-6688
-----------------------------------------------------
Fax | 816-436-0988
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT
-----------------------------------------------------
Name | JAMES LYNN VAN HOOSER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 816-436-6688
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 043232080711
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------