NPIMap

Organization Active NPI

Woodward Youth Corporation

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Woodward, IA
National Provider Identifier
1962806158
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
WOODWARD YOUTH CORPORATION
Doing business as
Forest Ridge Youth Services
Practice address
1251 334TH St
Woodward, IA 50276-7509
Phone
(515) 795-2267
NPI assigned
Oct 16, 2014
Organization subpart
Yes
Parent organization
SEQUEL YOUTH AND FAMILY SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Authorized official

Name
Mr. Bill Dean
Title
Vice President of Operations
Phone
(515) 795-2267

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

1251 334TH St
Woodward, IA 50276-7509

Mailing address

1251 334TH St
Woodward, IA 50276-7509

Other identifiers 1

IdentifierTypeStateIssuer
1140012MedicaidIA

Other names 1

  • Forest Ridge Youth Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Woodward Academy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1413417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413417600000",
    "number": "1962806158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 334TH ST",
            "city": "WOODWARD",
            "state": "IA",
            "postal_code": "502767509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 334TH ST",
            "city": "WOODWARD",
            "state": "IA",
            "postal_code": "502767509",
            "telephone_number": "515-795-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODWARD YOUTH CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEQUEL YOUTH AND FAMILY SERVICES, LLC",
        "enumeration_date": "2014-10-16",
        "last_updated": "2014-10-16",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "515-795-2267",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1140012",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Ridge Youth Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodward, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; 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.