Provider Demographics
NPI:1154207900
Name:POLAR STAR PSYCHIATRY LLC
Entity type:Organization
Organization Name:POLAR STAR PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY MENTAL HEALTH NURSE P.
Authorized Official - Prefix:
Authorized Official - First Name:AMERICA
Authorized Official - Middle Name:KARINA
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:720-743-5627
Mailing Address - Street 1:6833 S DAYTON ST # 104
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3624
Mailing Address - Country:US
Mailing Address - Phone:918-636-7230
Mailing Address - Fax:720-647-0194
Practice Address - Street 1:750 W DIMOND BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1515
Practice Address - Country:US
Practice Address - Phone:720-743-5627
Practice Address - Fax:720-647-0194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)