Woodside Healthcare

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

08041139 Issued in VA

Legal business name

WOODSIDE HEALTHCARE

Practice address

4309 Kenwood Dr
Woodbridge, VA 22193-5282

Phone

(240) 750-0045

NPI assigned

Apr 25, 2016

Last updated

Apr 25, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Isaiah A Teasley

Title

Ceo

Phone

(240) 750-0045

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461542400000",
    "number": "1356796668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SOUTHERN NIGHT LN",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793268",
            "telephone_number": "240-750-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 KENWOOD DR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935282",
            "telephone_number": "240-750-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSIDE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-25",
        "last_updated": "2016-04-25",
        "status": "A",
        "authorized_official_last_name": "TEASLEY",
        "authorized_official_first_name": "ISAIAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-750-0045"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "08041139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Woodbridge SH Lessee, LLC (HarborChase of Prince William Commons)
• Woodbridge Therapy Group LLC
• Diamond-Essence Aleya Woodhouse
• John Alexander Woods
• Natika C Woods, MSN, APRN, FNP-BC
• Monica E. Woropaj, LPC
• Katrina Nichole Worthington, LMHP-R
• Jo Ann Elizabeth Wright, CRNA
• Margaret Lilah Wright, RESIDENT
• Nicole Wright

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; 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.