Wood Lane Residential Services, Inc.

LBN: Wood Lane Residential Services, Inc.
Wood Lane Residential Services, Inc. is an health care organization with primary practice located at 349 W Main St. , Portage OH 43451. The organization recently has 2 registered licenses in different health care specialties including Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities. Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities is the primary health care specialty. Wood Lane Residential Services, Inc. can be contacted via phone (419) 353-9577, or through Blakely, Jessica via phone (419) 353-9577.

Contact Information

Primary practice address
349 W Main St. Portage OH 43451
Phone: (419) 353-9577
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Blakely, Jessica
Phone: (419) 353-9577

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X Ohio
Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities 385HR2060X Ohio

Profile Details

NPI number 1215029525
LBN Legal business name Wood Lane Residential Services, Inc.
DBA Doing business as
Authorized official Blakely, Jessica
Entity Organization
Organization subpart 1 No
Enumeration date Sep 28th, 2006
Last updated Jul 21st, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215029525 NPPES
Ohio MEDICAID 36G261
Ohio MEDICAID 36G260
Ohio MEDICAID 36G381
Ohio MEDICAID 2585751
Ohio MEDICAID 36G344
Ohio MEDICAID 36G475
Ohio MEDICAID 36G087
Ohio MEDICAID 36G345
Ohio MEDICAID 36G474

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