Provider Demographics
NPI:1992828180
Name:WOODS, FLOYD (CAC 1)
Entity Type:Individual
Prefix:
First Name:FLOYD
Middle Name:
Last Name:WOODS
Suffix:
Gender:M
Credentials:CAC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1352 TERRACE ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-3545
Mailing Address - Country:US
Mailing Address - Phone:231-726-3582
Mailing Address - Fax:231-722-6933
Practice Address - Street 1:1352 TERRACE ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-3545
Practice Address - Country:US
Practice Address - Phone:231-726-3582
Practice Address - Fax:231-722-6933
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-03601101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)