Organization
NORTHSTAR REGIONAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISA L JOHNSON (CONTRACTING/CREDENTIALING/BILLING)
(952) 856-3932
Entity
Organization
Contact information
Practice address
1045 STOUGHTON AVE, CHASKA, MN 55318-2149
(952) 974-3999
Mailing address
1045 STOUGHTON AVE, CHASKA, MN 55318-2149
(952) 448-6557
(952) 448-6047
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/17/2015
Last updated
04/22/2025
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