Organization
NORTHSTAR HOSPITAL LLC
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA HARTLEY (EXECUTIVE DIRECTOR)
(774) 521-7092
Entity
Organization
Contact information
Practice address
8911 E ORME ST, WICHITA, KS 67207-2423
(316) 686-7884
Mailing address
8911 E ORME ST, WICHITA, KS 67207-2423
(316) 686-7884
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
251B00000X
Case Management Agency
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/25/2023
Last updated
10/25/2024
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