Northwest Residence, Inc. in Brooklyn Center - Community Based Residential Treatment Facility, Mental Illness
Northwest Residence, Inc. - NPI 1629198965
Northwest Residence, Inc. is a Community Based Residential Treatment Facility, Mental Illness in Brooklyn Center, Minnesota. Northwest Residence, Inc. practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Northwest Residence, Inc. is 1629198965. The last update date is 2013-05-24.
Northwest Residence, Inc.'s current location address is 4408 69th Ave N, Brooklyn Center, Minnesota. You can contact this provider via phone number 7635663650 and fax number 7635664217. The mailing address for Northwest Residence, Inc. is 4408 69th Ave N, Brooklyn Center, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Northwest Residence, Inc. |
|---|---|
| Address | 4408 69th Ave N, Brooklyn Center, Minnesota |
| Phone Number | 7635663650 |
| Fax Number | 7635664217 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Ollendick Wright M Diane |
| Credentials | LICSW |
| Telephone Number | 7632771038 |
NPI Number Detail
| NPI Number | 1629198965 |
|---|---|
| Provider Enumeration Date | 2007-03-30 |
| Last Updated Date | 2013-05-24 |
Provider Mailing Address Detail
| Address | 4408 69th Ave N |
|---|---|
| City | Brooklyn Center |
| State | Minnesota (MN) |
| Post Code | 554291739 |
| Phone Number | 7635663650 |
| Fax Number | 7635664217 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
|
Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
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What is the unique 10-digit identifier code issued to Northwest Residence, Inc. by the Centers for Medicare & Medicaid Services?
The Northwest Residence, Inc. has been assigned the NPI (National Provider Identifier) 1629198965 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Northwest Residence, Inc. is located?
The Northwest Residence, Inc. is situated at the following address: 4408 69Th Ave N, Brooklyn Center, MN, 554291739.
What is Northwest Residence, Inc.'s specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Northwest Residence, Inc.'s specialized field of practice is Community Based Residential Treatment Facility, Mental Illness, and the corresponding taxonomy code that categorizes this area of specialization is 320800000X.
When did the Northwest Residence, Inc. receive its 1629198965?
The Northwest Residence, Inc. was issued its 1629198965 on 2007-03-30, which is the date when the organization was assigned this unique identifier.
When was the information regarding Northwest Residence, Inc. most recently updated?
The details pertaining to the Northwest Residence, Inc., including its address, specialty, and other relevant information, were last refreshed on 2013-05-24.