NPIMap

Organization Active NPI

Wood Lane Residential Services

  • Intellectual Disabilities Intermediate Care Facility
  • Walbridge, OH
National Provider Identifier
1649891029
Registry record updated Apr 27, 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
300 Elm St
Walbridge, OH 43465-1140
Phone
(419) 666-2344
NPI assigned
Apr 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 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

300 Elm St
Walbridge, OH 43465-1140

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": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1649891029",
    "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": "300 ELM ST",
            "city": "WALBRIDGE",
            "state": "OH",
            "postal_code": "434651140",
            "telephone_number": "419-666-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD LANE RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "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 Walbridge, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.