Provider Demographics
NPI:1013484336
Name:WOODLAND HOME CARE, LLC
Entity Type:Organization
Organization Name:WOODLAND HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLOUGHBY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:989-745-5164
Mailing Address - Street 1:305 LILLIAN ST
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-7872
Mailing Address - Country:US
Mailing Address - Phone:989-745-5164
Mailing Address - Fax:
Practice Address - Street 1:395 ISENHAUER RD
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738-8634
Practice Address - Country:US
Practice Address - Phone:989-745-6302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health