MEDICARE: NORTHWESTERN HUMAN SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	CW015257	PA

General Provider Information

NPI Number	:	1144315136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWESTERN HUMAN SERVICES

Provider Business Mailing Address
First Line	:	108 DRAYTON CIR
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-6404
Country	:	US
Telephone Number	:	215-412-3328
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N BROAD ST
Second Line	:
City	:	LANSDALE
State	:	PA
Zip	:	19446-2414
Country	:	US
Telephone Number	:	215-631-7814
Fax Number	:	215-855-6454

Authorized Official
Title or Position	:	EXCECUTIVE VICE PRESIDENT
Name	:	MR. MICHAEL A. BARTON
Credential	:
Telephone Number	:	215-836-3111

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	10/01/2021

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