WOOD LANE RESIDENTIAL SERVICES, INC. (NPI# 1528596467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528596467 |
| Entity Type | Organization |
| Organization Name | WOOD LANE RESIDENTIAL SERVICES, INC. |
| Practice Address |
1005 Klotz Rd Bowling Green OH 43402-4820 |
| Mailing Address |
545 Pearl St Bowling Green OH 43402-2784 |
| Practice Telephone | 4193539577 |
| Mailing Telephone | 4193539577 |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2017-05-23 |
| Authorized Official Name | JESSICA BLAKELY (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4193539577 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 32700 | OH | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215029525 | Wood Lane Residential Services, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 349 W Main St., Portage, OH 43451 | 2006-09-28 |
| 1275154569 | Wood Lane Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 353 W Main St, Portage, OH 43451-9802 | 2020-04-28 |
| 1144759739 | Wood Lane Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 1009 Klotz Rd, Bowling Green, OH 43402-4820 | 2017-06-07 |
| Street Address |
1005 KLOTZ RD |
| City | BOWLING GREEN |
| State | OH |
| Zip Code | 43402-4820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861646101 | Wood County Board of Mr/dd | Nursing Care | 1005 Klotz Rd, Bowling Green, OH 43402-4820 | 2008-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316592017 | Danielle Urbaniak | Pharmacist | 722-740 South Main St, Bowling Green, OH 43402 | 2019-08-08 |
| 1013485648 | Julie Marie Knapp | Counselor | 219 South Church Street, Bowling Green, OH 43402 | 2018-11-13 |
| 1477065274 | Elizabeth Marie Leber | Social Worker | 1045 Klotz Rd., Bowling Green, OH 43402 | 2017-11-02 |
| 1558871913 | Genoa Healthcare, LLC | Pharmacy | 1010 N Prospect St Ste 56, Bowling Green, OH 43402 | 2017-10-11 |
| 1093224933 | Kevin Wagner | Contractor | 19644 Hull Prairie Rd, Bowling Green, OH 43402 | 2017-09-22 |
| 1487102273 | Mary Ann Bostdorff | Registered Nurse | 1011 North Prospect St., Bowling Green, OH 43402 | 2016-09-21 |
| 1174927354 | Kristy Siegle | Counselor | 1010 North Prospect, Bowling Green, OH 43402 | 2014-10-16 |
| 1366846560 | Timothy M Burkart | Pharmacist | 1840 E. Gypsy Lane Rd, (wood County Health Department), Bowling Green, OH 43402 | 2014-10-16 |
| 1144629411 | Ledeithra Denise Mckinney | Speech-Language Pathologist | 1921 East Gypsy Lane Rd., Bowling Green, OH 43402 | 2014-08-22 |
| 1558701607 | Mark Joseph Kleeberger | Physical Therapy Assistant | 1180 N Main St, Bowling Green, OH 43402 | 2013-07-02 |
| Find all providers in zip 43402 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083235378 | Wood Lane Residential Services | Intermediate Care Facility, Mentally Retarded | 531 Conneaut Ave, Bowling Green, OH 43402-2237 | 2020-04-28 |
| 1144759739 | Wood Lane Residential Services, Inc. | Intermediate Care Facility, Mentally Retarded | 1009 Klotz Rd, Bowling Green, OH 43402-4820 | 2017-06-07 |
| 1730350869 | Alternative Youth Services, Inc. | Intermediate Care Facility, Mentally Retarded | 2530 Scottsville Rd, Suite # 100, Bowling Green, KY 42104-6310 | 2008-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020616 | Viaquest Healthcare Central | Intermediate Care Facility, Mentally Retarded | 6873 Dave Dr, Madison, OH 44057-1105 | 2020-10-15 |
| 1366056210 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 410 Abbe Road, Sheffield Lake, OH 44054 | 2020-09-08 |
| 1619581568 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 460 Abbe Road, Sheffield Lake, OH 44054 | 2020-09-08 |
| 1548874589 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 448 Opportunity Way, Lagrange, OH 44050-9021 | 2020-09-08 |
| 1194339044 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 5230 East Lake Road, Sheffield Lake, OH 44054 | 2020-09-08 |
| 1326652496 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 801 Robinwood, Sheffield Lake, OH 44054 | 2020-09-04 |
| 1346854890 | Res-care Ohio, Inc. | Intermediate Care Facility, Mentally Retarded | 426 Opportunity Way, Lagrange, OH 44050-9021 | 2020-09-02 |
| 1144841438 | Wood Lane Residential Services | Intermediate Care Facility, Mentally Retarded | 355 W Main St., Portage, OH 43451-9802 | 2020-04-28 |
| 1689209009 | 333 Therapeutics Consulting LLC | Intermediate Care Facility, Mentally Retarded | 331 Toby Rd, Eaton, OH 45320-9529 | 2020-03-05 |
| 1700418258 | Jewish Family Service Association | Intermediate Care Facility, Mentally Retarded | 8132 Cedar Rd, Chesterland, OH 44026-3548 | 2020-02-12 |
| Find all providers with the same taxonomy | ||||
| City | BOWLING GREEN |
| Zip Code | 43402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.