Organization
NORTH STAR CENTER, LLC.
Active
Parent organization
NORTH STAR CENTER, LLC.
Other names
Outpatient Introspection Center, North Star Treatment Center, North Star Day Treatment
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH STAR CENTER, LLC.
Authorized official
MRS. JANETTE HAWS AHQUIN (MANAGER)
(435) 229-4889
Entity
Organization
Contact information
Practice address
254 S STATE ST BLDG A, LA VERKIN, UT 84745-5633
(800) 635-0165
Mailing address
690 W. STATE STREET, PMB 34, HURRICANE, UT 84737-1972
(800) 635-0165
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
51933
UT
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
63460
UT
323P00000X
Psychiatric Residential Treatment Facility
Primary
39297
UT
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39297
STATE RTC LICENSE
UT
01
—
51933
DAY TREATMENT LICENSE
UT
01
—
63460
OUTPATIENT TREATMENT LICENSE
UT
Enumeration date
08/09/2018
Last updated
12/13/2018
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