NPIMap

Organization Active NPI

Woodland Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Willmar, MN
National Provider Identifier
1104909779
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
830946 Issued in MN
Legal business name
WOODLAND CENTERS
Practice address
1125 6TH St SE
Willmar, MN 56201-0787
Phone
(320) 235-4613
Fax
(320) 231-9140
NPI assigned
Oct 24, 2006
Last updated
Aug 3, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
WOODLAND CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2017

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

Authorized official

Name
Dr. Ashley KjosNPI 1588984074
Title
Ceo
Phone
(320) 235-4613

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 830946 MN Primary

Addresses

Primary practice location

1125 6TH St SE
Willmar, MN 56201-0787

Mailing address

1125 6TH St SE
Willmar, MN 56201-0787
Phone (320) 235-4613

Other names 1

  • West Central Community Services Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
West Central Comm SVC C6 organizations share this tax ID, including this one
Part of
West Central Comm SVC C

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501718400000",
    "number": "1104909779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562010787",
            "telephone_number": "320-235-4613",
            "fax_number": "320-231-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 6TH ST SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562010787",
            "telephone_number": "320-235-4613",
            "fax_number": "320-231-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOODLAND CENTERS",
        "enumeration_date": "2006-10-24",
        "last_updated": "2017-08-03",
        "status": "A",
        "authorized_official_last_name": "KJOS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-235-4613",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "830946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Central Community Services Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Willmar, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.