Organization
NORTHWEST YOUTH DISCOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD CHARLES STREETER M.S., M.ED. (EXECUTIVE DIRECTOR)
(541) 647-9609
Entity
Organization
Contact information
Practice address
61850 DOBBIN RD, BEND, OR 97702-9536
(541) 647-9609
(541) 389-1648
Mailing address
70 SW CENTURY DR STE 100-118, BEND, OR 97702-3557
(541) 647-9609
(541) 389-1648
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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