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Northwest Journey - Wisconsin Rapids Day Treatm

Organization Active NPI Adolescent and Children Mental Health Clinic/Center · Wisconsin Rapids, WI

NPI 1669599288 · NPPES record last updated Sep 23, 2010

Key facts

NPI
1669599288
Entity type
Organization (NPI type 2)
Primary specialty
Adolescent and Children Mental Health Clinic/Center 261QM0855X
License
2291 (WI)
Legal business name
NORTHWEST JOURNEY - WISCONSIN RAPIDS DAY TREATM
Practice address
110 24TH St S
Wisconsin Rapids, WI 54494-1906
Phone
(715) 424-5040
Fax
(715) 424-5720
NPI assigned
Mar 26, 2007
Organization subpart
Yes
Parent organization (as reported)
NORTHWEST COUNSELING AND GUIDANCE CLINIC

Authorized official

Name
Mr. Nick Kalambokidis
Title
Cfo
Phone
(715) 327-4402

Corporate family (same tax ID) 21

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

National Provider Directory

Tax ID family
Northwest Counseling Center (22 organizations share this tax ID)
Part of
Northwest Counseling Center

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 2291 WI Yes

Addresses

Primary practice location

110 24TH St S
Wisconsin Rapids, WI 54494-1906

Mailing address

110 24TH St S
Wisconsin Rapids, WI 54494-1906
Phone (715) 424-5040

Other identifiers

IdentifierTypeStateIssuer
85575OtherMNPREFERRED ONE
43006100MedicaidWI
42626OtherMNHEALTH PARTNERS

Other providers in Wisconsin Rapids, WI

All providers in Wisconsin Rapids, WI · Adolescent and Children Mental Health Clinic/Center in Wisconsin

Sources for this page

Verify at the official NPI Registry.