NPIMap

Organization Active NPI

Northwest Youth Discovery

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Bend, OR
National Provider Identifier
1336565993
Registry record updated Mar 6, 2014
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
9 NW 15TH St
Bend, OR 97701-3102
Phone
(541) 647-9609
NPI assigned
Mar 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

9 NW 15TH St
Bend, OR 97701-3102

Mailing address

9 NW 15TH St
Bend, OR 97701-3102
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.

NPI Registry JSON

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1336565993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 NW 15TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013102",
            "telephone_number": "541-647-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NW 15TH ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013102",
            "telephone_number": "541-647-9609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST YOUTH DISCOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "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.ED."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "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 Mar 6, 2014; 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.