# NORTHWEST CHILDREN'S HOME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Community Based Counseling, Residential Facility
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245368224
- **Authorized official:** MRS. JENNY SKEELS (BUSINESS OFFICE MANGER)
- **Authorized official phone:** (208) 743-9404

## Contact information

- **Practice address:** 419 22ND AVE, LEWISTON, ID 83501-3812
- **Practice address phone:** (208) 743-9404
- **Mailing address:** 419 22ND AVE, LEWISTON, ID 83501-3812
- **Mailing address phone:** (208) 743-9404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | LCPC-2754 | ID | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/01/2007
- **Last updated:** 02/06/2020