Organization
NVW NEWCO, LLC
Active
Other names
Deschutes Wilderness Therapy, New Vision Wilderness
Organization subpart
No
Provider details
NPI number
Authorized official
SHARNELL SPENCER (CREDENTIALING MANAGER)
(661) 239-6923
Entity
Organization
Contact information
Practice address
160 SCALEHOUSE LOOP, SUITE 160, BEND, OR 97702-1284
(541) 312-4316
(541) 312-4350
Mailing address
5500 MING AVE STE 410, BAKERSFIELD, CA 93309-4631
(661) 622-4132
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
0222
OR
323P00000X
Psychiatric Residential Treatment Facility
Primary
0222
OR
Other
Enumeration date
04/15/2015
Last updated
04/14/2025
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