Provider Demographics
NPI:1992411052
Name:INSIGHT NORTHWEST RECOVERY
Entity type:Organization
Organization Name:INSIGHT NORTHWEST RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOTLIB
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, CADC III, M
Authorized Official - Phone:541-357-9433
Mailing Address - Street 1:132 E BROADWAY STE 730
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3160
Mailing Address - Country:US
Mailing Address - Phone:541-357-9433
Mailing Address - Fax:
Practice Address - Street 1:1776 MILLRACE DR # 202
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97403-2536
Practice Address - Country:US
Practice Address - Phone:541-203-0539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health