Provider Demographics
NPI:1770256612
Name:NORTHWOOD CHILDREN'S HOME SOCIETY INC
Entity Type:Organization
Organization Name:NORTHWOOD CHILDREN'S HOME SOCIETY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAIMIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GOETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-728-7176
Mailing Address - Street 1:714 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4906
Mailing Address - Country:US
Mailing Address - Phone:218-724-8815
Mailing Address - Fax:218-724-0251
Practice Address - Street 1:1131 N 11TH AVE E
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-1517
Practice Address - Country:US
Practice Address - Phone:218-724-7953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home