| Northern Star Healing, Pllc | |
|
1530 Fairway Street Mountain Home ID 83647 | |
| (208) 794-0048 | |
| (855) 471-0759 |
| Full Name | Northern Star Healing, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1530 Fairway Street, Mountain Home, Idaho |
| Authorized Official Name and Position | Daniel Eli Novak (OWNER) |
| Authorized Official Contact | 2087940048 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Star Healing, Pllc 1530 Fairway Street Mountain Home ID 83647 Ph: (208) 794-0048 | Northern Star Healing, Pllc 1530 Fairway Street Mountain Home ID 83647 Ph: (208) 794-0048 |
| NPI Number | 1003497975 |
|---|---|
| Provider Enumeration Date | 04/21/2021 |
| Last Update Date | 04/21/2021 |
| Certification Date | 04/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003497975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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