Provider Demographics
NPI:1023322690
Name:THE NORTHSTAR CENTER
Entity type:Organization
Organization Name:THE NORTHSTAR CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:GERMAIN
Authorized Official - Last Name:FIEVET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-385-8657
Mailing Address - Street 1:1195 NW WALL ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-1965
Mailing Address - Country:US
Mailing Address - Phone:541-385-8657
Mailing Address - Fax:541-385-0997
Practice Address - Street 1:1195 NW WALL ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-1965
Practice Address - Country:US
Practice Address - Phone:541-385-8657
Practice Address - Fax:541-385-0997
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRC HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children