Provider Demographics
NPI:1689961500
Name:NORTH STAR TREATMENT GROUP, LLC
Entity Type:Organization
Organization Name:NORTH STAR TREATMENT GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TALAL
Authorized Official - Middle Name:SAGER
Authorized Official - Last Name:HATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-229-6302
Mailing Address - Street 1:130 ANDOVER PARK E STE B105
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2907
Mailing Address - Country:US
Mailing Address - Phone:206-229-6302
Mailing Address - Fax:206-241-1688
Practice Address - Street 1:130 ANDOVER PARK E STE B105
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2907
Practice Address - Country:US
Practice Address - Phone:206-229-6302
Practice Address - Fax:206-241-1688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA17139500251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health