Provider Demographics
NPI:1356893580
Name:NEW DIRECTIONS NORTHWEST INC.
Entity type:Organization
Organization Name:NEW DIRECTIONS NORTHWEST INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEER SUPPORT SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TIA
Authorized Official - Middle Name:RALYNN
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-523-3646
Mailing Address - Street 1:2200 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-2615
Mailing Address - Country:US
Mailing Address - Phone:541-523-3646
Mailing Address - Fax:541-523-7602
Practice Address - Street 1:2200 4TH ST
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-2615
Practice Address - Country:US
Practice Address - Phone:541-523-3646
Practice Address - Fax:541-523-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service