Woodridge of Galesburg LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WOODRIDGE OF GALESBURG LLC

Practice address

261 N Linwood Rd
Galesburg, IL 61401-3279

Phone

(309) 344-4100

Fax

(309) 344-4101

NPI assigned

Dec 15, 2008

Organization subpart

No

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

Authorized official

Name

Marshall A Miaer

Title

Manager

Phone

(847) 679-8219

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1972748242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N LINWOOD RD",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614013279",
            "telephone_number": "309-344-4100",
            "fax_number": "309-344-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 N LINWOOD RD",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614013279",
            "telephone_number": "309-344-4100",
            "fax_number": "309-344-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODRIDGE OF GALESBURG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-15",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "MIAER",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-679-8219"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2634122952",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christy Kay Wingo, BSN, RN
• Andrea Louise Winking, RN BSN
• Dina B Witter, APN
• David Woltz, PHARMD
• Sandra Lynn Wood, QMHP,RN
• Hailey Worden
• Theresa Nicole Workheiser, LPCC
• Stacey Wyant, LCSW
• Lawrence D Yee, LCPC
• Christine Marie Young, RN

• Assisted Living Facility in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Assisted Living Facility in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.