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NORTHWEST RESIDENCE, INC.
NPI 1629198965
Community Based Residential Treatment Facility, Mental Illness in Brooklyn Center, MN

Active since March 30, 2007
4408 69TH AVE N, BROOKLYN CENTER, MN 55429(763) 566-3650(763) 566-4217 Get Directions Write a Review

NPPES record last updated: May 24, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Northwest Residence, Inc. NPPES

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

NORTHWEST RESIDENCE, INC. (NPI 1629198965) is a healthcare organization registered as a community based residential treatment facility, mental illness in Brooklyn Center, Minnesota and active in the NPI registry since March 2007. The organization lists Diane M Ollendick Wright, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1629198965
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameNORTHWEST RESIDENCE, INC.
Location Address4408 69TH AVE NBrooklyn Center, MN 55429-1739
Mailing Address4408 69th Ave NBrooklyn Center, MN 55429-1739 · (763) 566-3650 · Fax (763) 566-4217
Phone(763) 566-3650
Fax(763) 566-4217
Organization SubpartNo
Authorized OfficialDiane M Ollendick WrightExecutive Director · (763) 277-1038
Enumeration DateMarch 30, 2007
Last NPPES UpdateMay 24, 2013
✔ NPI 1629198965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
4408 69TH AVE N, Brooklyn Center, MN 55429
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Other Identifiers 1

Medicare UPIN283666100MN

Other Providers at the Same Location NPPES 4

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

MR. MATTHEW LOUIS SCHAUT LPCC
Counselor (Professional)
4408 69TH AVE N
BROOKLYN CENTER, MN 55429
Hennepin County (763) 566-3650
RESCARE MINNESOTA, INC.
Community/Behavioral Health
4408 69TH AVE N
BROOKLYN CENTER, MN 55429
Hennepin County (763) 566-3650
MR. ANDREW J. THOMPSON MSW, LICSW
Social Worker (Clinical)
4408 69TH AVE N
BROOKLYN CENTER, MN 55429
Hennepin County (763) 566-3650
APRIL MARIE OLSON LICSW
Social Worker (Clinical)
4408 69TH AVE N
BROOKLYN CENTER, MN 55429
Hennepin County (763) 566-3650

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 Residence, Inc.'s NPI number?

The NPI number for Northwest Residence, Inc. is 1629198965. It was assigned to this organization in the NPPES registry on March 30, 2007.

Where is Northwest Residence, Inc. located?

Northwest Residence, Inc. is located at 4408 69th Ave N, Brooklyn Center, MN 55429. The listed phone number is (763) 566-3650.

What is Northwest Residence, Inc.'s specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Northwest Residence, Inc. was last updated on May 24, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.