Provider Demographics
NPI:1124899406
Name:NORTH STAR ACHIEVEMENT CENTER
Entity type:Organization
Organization Name:NORTH STAR ACHIEVEMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATSIKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-689-3372
Mailing Address - Street 1:PO BOX 436401
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40253-6401
Mailing Address - Country:US
Mailing Address - Phone:502-689-3372
Mailing Address - Fax:
Practice Address - Street 1:1000 LAKE FOREST PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-5149
Practice Address - Country:US
Practice Address - Phone:502-689-3372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services