Organization
NVW NEWCO, LLC
Active
Other names
Northwoods Wilderness Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
SHARNELL SPENCER (CREDENTIALING MANAGER)
(661) 239-6923
Entity
Organization
Contact information
Practice address
W10649 PERKINSTOWN AVE, MEDFORD, WI 54451-8915
(715) 748-0251
Mailing address
5500 MING AVE STE 410, BAKERSFIELD, CA 93309-4631
(661) 622-4132
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/08/2015
Last updated
04/14/2025
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