Provider Demographics
NPI:1508123548
Name:WOODVIEW HOME CARE LLC
Entity Type:Organization
Organization Name:WOODVIEW HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:AUGUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-969-2000
Mailing Address - Street 1:3417 EAST STATE BLVD.
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46805-4803
Mailing Address - Country:US
Mailing Address - Phone:260-969-2000
Mailing Address - Fax:260-969-0323
Practice Address - Street 1:3417 EAST STATE BLVD.
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-4803
Practice Address - Country:US
Practice Address - Phone:260-969-2000
Practice Address - Fax:260-969-0323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health