Organization
BERRIEN MENTAL HEALTH AUTHORITY
Active
Organization
BERRIEN MENTAL HEALTH AUTHORITY
Active
Other names
NorthStar Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLEN R EDLEFSON (CEO)
(269) 934-1611
Entity
Organization
Contact information
Practice address
2500 NILES RD STE 7, SAINT JOSEPH, MI 49085-3268
(269) 982-7844
(269) 982-1783
Mailing address
2500 NILES RD STE 7, SAINT JOSEPH, MI 49085-3268
(269) 982-7844
(269) 982-1783
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
750910476
BCBS PIN #
MI
Enumeration date
06/17/2006
Last updated
09/07/2010
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