# NORTHWEST YOUTH DISCOVERY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275085128
- **Authorized official:** MR. RICHARD CHARLES STREETER M.S., M.ED. (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (541) 647-9609

## Contact information

- **Practice address:** 61850 DOBBIN RD, BEND, OR 97702-9536
- **Practice address phone:** (541) 647-9609
- **Practice address fax:** (541) 389-1648
- **Mailing address:** 70 SW CENTURY DR STE 100-118, BEND, OR 97702-3557
- **Mailing address phone:** (541) 647-9609
- **Mailing address fax:** (541) 389-1648

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/26/2016
- **Last updated:** 10/26/2016