Woods Manor

Primary specialty

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

Legal business name

WOODS MANOR

Practice address

1505 S Academy St
Glassboro, NJ 08028-3368

Phone

(856) 244-8072

Fax

(856) 537-5769

NPI assigned

Dec 22, 2019

Last updated

Jul 31, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

WOODS MANOR LLCAs reported in NPPES

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

Authorized official

Name

Ms. Tammy WoodsNPI 1912459512

Title

Ceo

Phone

(856) 203-4195

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Woods Manor5 organizations share this tax ID, including this one

Part of

Woods Manor

Other organizations with this tax ID 4

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

• Woods Manor

  • Community/Behavioral Health Agency
  • Woodbury, NJ
  • NPI 1700338308
  NPD tax ID
• Woods Manor

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Glassboro, NJ
  • NPI 1821638180
  NPD tax ID
• Woods Manor LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Glassboro, NJ
  • NPI 1699383745
  NPD tax ID
• Woods Manor LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Glassboro, NJ
  • NPI 1861071987
  NPD tax ID

Practitioners 1

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.

• Tammy Woods

  • Community/Behavioral Health Agency
  • Deptford, NJ
  • NPI 1912459512
  Authorized official Same address or phone

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

{
    "created_epoch": "1576972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1568001527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 STEEPLECHASE CT",
            "city": "DEPTFORD",
            "state": "NJ",
            "postal_code": "080966810",
            "telephone_number": "856-244-8072",
            "fax_number": "856-537-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 S ACADEMY ST",
            "city": "GLASSBORO",
            "state": "NJ",
            "postal_code": "080283368",
            "telephone_number": "856-244-8072",
            "fax_number": "856-537-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODS MANOR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOODS MANOR LLC",
        "enumeration_date": "2019-12-22",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-203-4195",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0568694",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Ezra Williams
• Valerie Ann Willis, LPC
• Malaysia Witherspoon
• David Allan Wolf, RPH
• Kelly Wood, LCSW
• Woods Manor
• Woods Manor LLC
• Woods Manor LLC
• Demetra Xenidis, PHARMD
• Vincent Young

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Glassboro, NJ
• Providers in Glassboro, NJ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.