Provider Demographics
NPI:1922245109
Name:NORTHWEST MENTAL HEALTH MANAGEMENT SERVICES, INC.
Entity Type:Organization
Organization Name:NORTHWEST MENTAL HEALTH MANAGEMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-655-6674
Mailing Address - Street 1:1020 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027-2155
Mailing Address - Country:US
Mailing Address - Phone:503-655-6674
Mailing Address - Fax:503-655-6737
Practice Address - Street 1:1020 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-2155
Practice Address - Country:US
Practice Address - Phone:503-655-6674
Practice Address - Fax:503-655-6737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness