Provider Demographics
NPI:1275283301
Name:NORTHWOODS LEARNING CENTER
Entity Type:Organization
Organization Name:NORTHWOODS LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:THIEL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:906-828-2088
Mailing Address - Street 1:703 E G ST
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-4131
Mailing Address - Country:US
Mailing Address - Phone:906-221-9608
Mailing Address - Fax:
Practice Address - Street 1:1075 WOODWARD AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:KINGSFORD
Practice Address - State:MI
Practice Address - Zip Code:49802-4434
Practice Address - Country:US
Practice Address - Phone:906-828-2088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty