NPIMap

Organization Active NPI

Northwest Youth Discovery

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Bend, OR
National Provider Identifier
1275085128
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
NORTHWEST YOUTH DISCOVERY
Practice address
61850 Dobbin Rd
Bend, OR 97702-9536
Phone
(541) 647-9609
Fax
(541) 389-1648
NPI assigned
Oct 26, 2016
Last updated
Oct 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Richard Charles Streeter, M.S., M.ED.NPI 1427406636
Title
Executive Director
Phone
(541) 647-9609

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU Primary

Addresses

Primary practice location

61850 Dobbin Rd
Bend, OR 97702-9536

Mailing address

70 SW Century Dr Ste 100-118
Bend, OR 97702-3557
Phone (541) 647-9609

National Provider Directory

National Provider Directory
Tax ID family
Northwest Youth Discovery3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

70 SW Century Dr
Ste 100118
Bend, OR 97702

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1275085128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 SW CENTURY DR STE 100-118",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023557",
            "telephone_number": "541-647-9609",
            "fax_number": "541-389-1648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61850 DOBBIN RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977029536",
            "telephone_number": "541-647-9609",
            "fax_number": "541-389-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST YOUTH DISCOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "STREETER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-647-9609",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S., M.ED."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.