Provider Demographics
NPI:1528934163
Name:WOODRUFF CORPORATION LLC.
Entity type:Organization
Organization Name:WOODRUFF CORPORATION LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-414-9516
Mailing Address - Street 1:1011 GREENOB DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2208
Mailing Address - Country:US
Mailing Address - Phone:937-414-9516
Mailing Address - Fax:937-414-9516
Practice Address - Street 1:1011 GREENOB DR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2208
Practice Address - Country:US
Practice Address - Phone:937-414-9516
Practice Address - Fax:937-414-9516
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADRIAN'S HAVEN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children