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General NPI Number Information
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NPI Number | 1336800515
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Entity Type | Organization
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Legal Business Name | NORTHWEST HEALTH SERVICES INC
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Dates
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Enumeration Date | 01/10/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 300 W BUSINESS HWY 36
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City | CHILLICOTHEE
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State | MO
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Zip | 64601
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Country | US
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Telephone | 816-271-8265
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 803886
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City | KANSAS CITY
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State | MO
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Zip | 64180-3886
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Country | US
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Telephone | 816-271-8265
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MATT YOUNGER
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Credential |
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Telephone | 816-271-8265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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