Provider Demographics
NPI:1700808755
Name:NORTHSTAR PARTNERING GROUP, LLC
Entity Type:Organization
Organization Name:NORTHSTAR PARTNERING GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER, PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:479-251-7827
Mailing Address - Street 1:2458 E JOYCE BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4519
Mailing Address - Country:US
Mailing Address - Phone:479-251-7827
Mailing Address - Fax:479-251-8522
Practice Address - Street 1:2458 E JOYCE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4519
Practice Address - Country:US
Practice Address - Phone:479-251-7827
Practice Address - Fax:479-251-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN/A261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service