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Organization
NORTH STAR ACT
Active
Organization
NORTH STAR ACT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD F COSICO-BERGE R.N. (STAFF NURSE)
(760) 432-9884
Entity
Organization
Contact information
Practice address
474 W VERMONT AVE, 104, ESCONDIDO, CA 92025-6584
(760) 432-9884
Mailing address
474 W VERMONT AVE, 104, ESCONDIDO, CA 92025-6584
(760) 432-9884
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
521816
DE
Other
Enumeration date
10/17/2007
Last updated
10/17/2007
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