# NORTH STAR ACT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093904831
- **Authorized official:** MR. DONALD F COSICO-BERGE R.N. (STAFF NURSE)
- **Authorized official phone:** (760) 432-9884

## Contact information

- **Practice address:** 474 W VERMONT AVE, 104, ESCONDIDO, CA 92025-6584
- **Practice address phone:** (760) 432-9884
- **Mailing address:** 474 W VERMONT AVE, 104, ESCONDIDO, CA 92025-6584
- **Mailing address phone:** (760) 432-9884

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | 521816 | DE | Yes |

## Other

- **Enumeration date:** 10/17/2007
- **Last updated:** 10/17/2007