Provider Demographics
NPI:1700239381
Name:WOODLAWN CARE AND REHAB LLC
Entity Type:Organization
Organization Name:WOODLAWN CARE AND REHAB LLC
Other - Org Name:ORCHARD GARDENS HEALTH AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-202-9844
Mailing Address - Street 1:1123 MCDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3320
Mailing Address - Country:US
Mailing Address - Phone:845-202-9844
Mailing Address - Fax:
Practice Address - Street 1:1600 S WOODLAWN BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-4728
Practice Address - Country:US
Practice Address - Phone:316-691-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHUVA HEALTH MANAGEMENT LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-19
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT175452Medicare Oscar/Certification