Provider Demographics
NPI:1871224246
Name:WOODEN GROUP HOME HELP
Entity Type:Organization
Organization Name:WOODEN GROUP HOME HELP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAWON
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-763-7101
Mailing Address - Street 1:22800 CIVIC CENTER DR APT 103-A
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-7140
Mailing Address - Country:US
Mailing Address - Phone:248-763-7101
Mailing Address - Fax:
Practice Address - Street 1:22800 CIVIC CENTER DR APT 103-A
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-7140
Practice Address - Country:US
Practice Address - Phone:248-763-7101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-17
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA