Organization
NORTHSTAR CLINICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK JOHNSON (CEO)
(980) 505-2353
Entity
Organization
Contact information
Practice address
322 LAMAR AVE STE 220, CHARLOTTE, NC 28204-2436
(980) 237-0401
Mailing address
322 LAMAR AVE STE 220, CHARLOTTE, NC 28204-2436
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2020
Last updated
05/01/2020
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