Woodlawn LP

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

NH4208 Issued in OK

Legal business name

WOODLAWN LP

Practice address

405 N 20TH St
Guthrie, OK 73044-2103

Phone

(405) 282-1517

Fax

(405) 282-9007

NPI assigned

Aug 16, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Greg Machtolff

Title

Manager

Phone

(405) 282-2600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PROVIDENCE HOUSE Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 37G102

Legal name

PROVIDENCE HOUSE

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

May 9, 2002

Last certification

Mar 11, 2026

Beds

16

Ownership / control type

Private (proprietary)

Most recent change of ownership

Sep 1, 2015

Facility address

405 North 20TH Street
Guthrie, OK 73044

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Colonial Estates Adult Day Care3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Woodlawn, LLC

  • Respite Care
  • Guthrie, OK
  • NPI 1205907631
  NPD tax ID
• Woodlawn, LLC

  • Respite Care
  • Pauls Valley, OK
  • NPI 1659458412
  NPD tax ID

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1679565709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 977",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730440977",
            "telephone_number": "405-282-2600",
            "fax_number": "405-282-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 N 20TH ST",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730442103",
            "telephone_number": "405-282-1517",
            "fax_number": "405-282-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAWN LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "MACHTOLFF",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-282-2600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OK",
            "license": "NH4208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100771000A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROVIDENCE HOUSE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie Williams
• Willow Creek Health Care LLC
• Rebecca Wisener
• Doris Faye Wolfe-Klingler, LPC
• Woodlawn LP
• Woodlawn, LLC
• WVL I LP
• WVL I LP
• Kenneth Wayne Yerton
• Kathleen E. Young

• Intellectual Disabilities Intermediate Care Facility in Guthrie, OK
• Providers in Guthrie, OK by specialty
• Intellectual Disabilities Intermediate Care Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.