Provider Demographics
NPI:1689825374
Name:NORTHWOOD'S GUIDANCE CENTER
Entity Type:Organization
Organization Name:NORTHWOOD'S GUIDANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-369-2215
Mailing Address - Street 1:PO BOX 897
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-0897
Mailing Address - Country:US
Mailing Address - Phone:715-369-2215
Mailing Address - Fax:715-369-2214
Practice Address - Street 1:705 E TIMBER DR
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-2859
Practice Address - Country:US
Practice Address - Phone:715-369-2215
Practice Address - Fax:715-369-2214
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE HUMAN SERVICE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-01
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42137800Medicaid
WI42137800Medicaid