NPIMap

Organization Active NPI

Wood Lane Residential Services

  • Intellectual Disabilities Intermediate Care Facility
  • Bowling Green, OH
National Provider Identifier
1083235378
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
WOOD LANE RESIDENTIAL SERVICES
Practice address
531 Conneaut Ave
Bowling Green, OH 43402-2237
Phone
(419) 353-2307
NPI assigned
Apr 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessica Blakely
Title
Ceo
Phone
(419) 353-9577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

531 Conneaut Ave
Bowling Green, OH 43402-2237

Mailing address

545 Pearl St
Bowling Green, OH 43402-2784
Phone (419) 353-9577

National Provider Directory

National Provider Directory
Tax ID family
Wood Lane Residential Services8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588032000000",
    "number": "1083235378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 PEARL ST",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022784",
            "telephone_number": "419-353-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 CONNEAUT AVE",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434022237",
            "telephone_number": "419-353-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD LANE RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "BLAKELY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-353-9577"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.