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Organization

NORTH STAR SUPPORTIVE SERVICES

Active
Other names
North Star Supportive Services
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PETER EKADU (MANAGERIAL OFFICIAL)
(989) 289-6499
Entity
Organization

Contact information

Practice address
103 OKABENA ST, OKABENA, MN 56161
(763) 350-1065
Mailing address
8910 CAMBRIDGE AVE N, BROOKLYN PARK, MN 55443

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251C00000X
Developmentally Disabled Services Day Training Agency
251E00000X
Home Health Agency
Primary
251J00000X
Nursing Care Agency
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
310400000X
Assisted Living Facility
320800000X
Mental Illness Community Based Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
385H00000X
Respite Care
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
04/22/2024
Last updated
05/03/2024
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