WOOD LANE RESIDENTIAL SERVICES (NPI# 1649891029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649891029 |
| Entity Type | Organization |
| Organization Name | WOOD LANE RESIDENTIAL SERVICES |
| Practice Address |
300 Elm St Walbridge OH 43465-1140 |
| Mailing Address |
545 Pearl St Bowling Green OH 43402-2784 |
| Practice Telephone | 4196662344 |
| Mailing Telephone | 4193539577 |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2020-04-27 |
| Authorized Official Name | JESSICA BLAKELY (CEO) |
| 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 | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144841438 | Wood Lane Residential Services | Intermediate Care Facility, Mentally Retarded | 355 W Main St., Portage, OH 43451-9802 | 2020-04-28 |
| 1316568603 | Wood Lane Residential Services | Intermediate Care Facility, Mentally Retarded | 351 W Main St, Portage, OH 43451-9802 | 2020-04-28 |
| 1083235378 | Wood Lane Residential Services | Intermediate Care Facility, Mentally Retarded | 531 Conneaut Ave, Bowling Green, OH 43402-2237 | 2020-04-28 |
| Street Address |
300 ELM ST |
| City | WALBRIDGE |
| State | OH |
| Zip Code | 43465-1140 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033363379 | Wood County Board of Mr/dd | Nursing Care | 300 Elm St, Walbridge, OH 43465-1140 | 2008-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548802366 | Mary Everly | Home Health Aide | 411 E Union St, Walbridge, OH 43465 | 2019-10-14 |
| 1871713396 | Matthew David Freytag | Dentist | 403 N Main St, Walbridge, OH 43465-1018 | 2007-04-26 |
| 1609094416 | Freytag Dental | Dentist | 403 N Main St, Walbridge, OH 43465-1018 | 2007-04-24 |
| 1336366889 | Jody Freytag | Dentist | 403 N Main St, Walbridge, OH 43465-1018 | 2007-04-19 |
| 1790032142 | Sherrie Ann Threet | Licensed Practical Nurse | 30630 Drouillard Rd, Lot #10, Walbridge, OH 43465-1032 | 2012-08-04 |
| 1932480415 | Christopher L Stack | Counselor | 5693 Blue Grass Dr, Walbridge, OH 43465-1148 | 2011-08-29 |
| 1184273658 | Brandon Oneail | Physician Assistant | 406 Allen St, Walbridge, OH 43465-1202 | 2019-09-08 |
| 1003380882 | Sunshine Inc. Residential and Support Services | Intermediate Care Facility, Mentally Retarded | 403 Allen St, Walbridge, OH 43465-1232 | 2019-01-15 |
| 1447504907 | Erica L. Davenport | Licensed Practical Nurse | 123 Elmwood Rd, Walbridge, OH 43465-1428 | 2012-11-06 |
| 1225468218 | Aaron Enterprises | Home Infusion | 113 Harwood Rd, Walbridge, OH 43465-1442 | 2013-11-12 |
| Find all providers in zip 43465 | ||||
| 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 |
|---|---|---|---|---|
| 1003380882 | Sunshine Inc. Residential and Support Services | Intermediate Care Facility, Mentally Retarded | 403 Allen St, Walbridge, OH 43465-1232 | 2019-01-15 |
| 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 | ||||
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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.