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NORTHWEST PASSAGE LTD
NPI 1235266065
Residential Treatment Facility, Emotionally Disturbed Children in Frederic, WI

Active since February 28, 2007CLIA 52D2245281 · Waiver
203 UNITED WAY DRIVE, FREDERIC, WI 54837(715) 327-4402(715) 327-4470 Get Directions Write a Review

NPPES record last updated: March 27, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Northwest Passage Ltd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NORTHWEST PASSAGE LTD (NPI 1235266065) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Frederic, Wisconsin and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through December 9, 2027 and lists Jackie J Maurer, Business Office Supervisor, as its authorized official.

NPPES Registry Identity

NPI1235266065
Entity TypeOrganization
Primary Taxonomy322D00000X
Legal Business NameNORTHWEST PASSAGE LTD
Location Address203 UNITED WAY DRIVEFrederic, WI 54837-8938
Mailing Address203 United Way DriveFrederic, WI 54837-8938 · (715) 327-4322 · Fax (715) 327-8509
Phone(715) 327-4402
Fax(715) 327-4470
Organization SubpartYesParent: Northwest Passage
Authorized OfficialJackie J MaurerBusiness Office Supervisor · (715) 327-4322
Enumeration DateFebruary 28, 2007
Last NPPES UpdateMarch 27, 2012
✔ NPI 1235266065 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
License✔ Licensed in WI · 560014
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
203 UNITED WAY DRIVE, Frederic, WI 54837
Open in Google Maps ↗

Other Identifiers 2

Medicaid43015400WI
Other3181NOMN · Bcbs Of Mn

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D2245281

Northwest Passage, Ltd · Frederic, WI
Active · expires Dec 9, 2027
CLIA Number52D2245281
Laboratory TypeTreatment Facility
Certificate Effective DateDecember 10, 2025
Certificate Expiration DateDecember 9, 2027
Laboratory DirectorSamantha Hughes
Laboratory Phone(715) 372-4402
Laboratory LocationNorthwest Passage, Ltd203 United Way Dr, Frederic, WI 54837
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NORTHWEST COUNSELING & GUIDANCE CLINIC
Clinic/Center (Mental Health (Including Community Mental Health Center))
203 UNITED WAY DRIVE
FREDERIC, WI 54837
Polk County (715) 327-4402
TARA L MITCHELL LPC
Counselor (Mental Health)
203 UNITED WAY DRIVE
FREDERIC, WI 54837
Polk County (715) 327-4402
TIMOTHY D NEWLIN LPC
Counselor (Mental Health)
203 UNITED WAY DRIVE
FREDERIC, WI 54837
Polk County (715) 327-4402

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Northwest Passage Ltd's NPI number?

The NPI number for Northwest Passage Ltd is 1235266065. It was assigned to this organization in the NPPES registry on February 28, 2007.

Where is Northwest Passage Ltd located?

Northwest Passage Ltd is located at 203 United Way Drive, Frederic, WI 54837. The listed phone number is (715) 327-4402.

What is Northwest Passage Ltd's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Does Northwest Passage Ltd hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D2245281) is associated with this NPI, valid through December 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Northwest Passage Ltd was last updated on March 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.