Provider Demographics
NPI:1245820802
Name:NORTHSTAR THERAPY CENTER LLC
Entity type:Organization
Organization Name:NORTHSTAR THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABSHIR
Authorized Official - Middle Name:YUSUF
Authorized Official - Last Name:HAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-822-7532
Mailing Address - Street 1:207 LYNDALE AVE SOUTH SUITE I
Mailing Address - Street 2:
Mailing Address - City:FARIBAULT
Mailing Address - State:MN
Mailing Address - Zip Code:55021
Mailing Address - Country:US
Mailing Address - Phone:614-822-7532
Mailing Address - Fax:
Practice Address - Street 1:207 LYNDALE AVE SOUTH SUITE I
Practice Address - Street 2:
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021
Practice Address - Country:US
Practice Address - Phone:614-822-7532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency