Provider Demographics
NPI:1376607374
Name:WOODLANDS, SERVING CENTRAL OHIO INC.
Entity Type:Organization
Organization Name:WOODLANDS, SERVING CENTRAL OHIO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:740-349-7066
Mailing Address - Street 1:195 UNION ST
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3919
Mailing Address - Country:US
Mailing Address - Phone:740-349-7066
Mailing Address - Fax:740-345-6028
Practice Address - Street 1:195 UNION ST
Practice Address - Street 2:SUITE B-1
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3919
Practice Address - Country:US
Practice Address - Phone:740-349-7066
Practice Address - Fax:740-345-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10193Medicaid
OH=========031Medicare UPIN
OH11610719Medicare UPIN
OHWO9330861Medicare ID - Type UnspecifiedGROUP PRACTICE NUMBER
OH050425262Medicare UPIN
OH050425262001Medicare UPIN
OH271568343001Medicare UPIN
OHBASW33311Medicare UPIN
OH10193Medicaid
OH11471412Medicare UPIN
OH11471699Medicare UPIN
OH11610641Medicare UPIN
OH271568343Medicare UPIN
OH3251-01Medicare UPIN
OH=========032Medicare UPIN
OHSCSW33171Medicare PIN