MEDICARE: WOOD CARE VIII INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	313M00000X	Nursing Facility/Intermediate Care Facility
2	314000000X	Skilled Nursing Facility	1070000431	MI

General Provider Information

NPI Number	:	1881755262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOOD CARE VIII INC

Provider Business Mailing Address
First Line	:	910 S WASHINGTON AVE
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48067-3216
Country	:	US
Telephone Number	:	248-543-7300
Fax Number	:	248-399-5300

Provider Business Practice Location Address
First Line	:	6700 WESTSIDE SAGINAW RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9325
Country	:	US
Telephone Number	:	989-667-9800
Fax Number	:	989-667-5900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KIMBERLY M. TACKETT
Credential	:
Telephone Number	:	248-543-7300

Provider Enumeration Date	:	12/12/2006
Last Update Date	:	03/20/2025

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