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General NPI Number Information
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NPI Number | 1538281738
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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 | 04/06/2007
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 3608 FARAON ST
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-3044
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Country | US
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Telephone | 816-364-6444
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Fax | 816-364-6929
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Provider Business Mailing Address
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Address Line | 2303 VILLAGE DR
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City | SAINT JOSEPH
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State | MO
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Zip | 64506-4954
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Country | US
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Telephone | 816-232-6168
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Fax | 816-232-2991
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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 | 816-232-6818
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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 | 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 #5
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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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