NPIMap

Organization Active NPI

Woodland Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Willmar, MN
National Provider Identifier
1295818862
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
802665 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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 802665 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 identifiers 2

IdentifierTypeStateIssuer
854855200MedicaidMN
45812WEOtherMNBCBS

Other names 1

  • West Central Community Services Center Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000600 MN Part B Supplier - Clinic/Group Practice 7416860457 Receives reassigned benefits from 54 practitioners
Practice locations: Litchfield, MN; Willmar, MN; Ortonville, MN; Olivia, MN; Montevideo, MN; Dawson, MN; Benson, MN

National Provider Directory

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

Other organizations with this tax ID 5

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

Locations

1209 Pacific Ave
Benson, MN 56215

114 N Holcombe Ave
Ste 230
Litchfield, MN 55355

902 W Lincoln Ave
Olivia, MN 56277
Phone (320) 523-2020

Practitioners & affiliated clinicians

Practitioners 59

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 59

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": "1658361600000",
    "number": "1295818862",
    "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": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-07-21",
        "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": "802665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "854855200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "45812WE",
            "state": "MN"
        }
    ],
    "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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.