Organization
NORTH STAR PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN R MORALES (BUSINESS MANAGER)
(505) 663-6220
Entity
Organization
Contact information
Practice address
195 EAST ROAD SUITE 104, LOS ALAMOS, NM 87544-4301
(505) 412-7756
(505) 662-8859
Mailing address
NORTH STAR PSYCHIATRIC SERVICES LLC, 195 EAST ROAD SUITE 104, LOS ALAMOS, NM 87544-4301
(505) 412-7756
(505) 662-8859
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067620752
—
NM
Enumeration date
01/19/2023
Last updated
01/19/2023
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