Provider Demographics
NPI:1093804098
Name:NORTHWEST FAMILY SERVICES, INC
Entity Type:Organization
Organization Name:NORTHWEST FAMILY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-327-2900
Mailing Address - Street 1:620 FLYNN ST
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:OK
Mailing Address - Zip Code:73717-2242
Mailing Address - Country:US
Mailing Address - Phone:580-327-2900
Mailing Address - Fax:580-327-1337
Practice Address - Street 1:620 FLYNN ST
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:OK
Practice Address - Zip Code:73717-2242
Practice Address - Country:US
Practice Address - Phone:580-327-2900
Practice Address - Fax:580-327-1337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty