Organization
NORTH STAR SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY JACKSON MSW (MEMBER)
(219) 322-9904
Entity
Organization
Contact information
Practice address
425 JOLIET ST, SUITE 309, DYER, IN 46311-1765
(219) 322-9904
(219) 322-9956
Mailing address
425 JOLIET ST, SUITE 309, DYER, IN 46311-1765
(219) 322-9904
(219) 322-9956
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
06/01/2010
Last updated
06/01/2010
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