Healthcare Provider Details

I. General information

NPI: 1700239381
Provider Name (Legal Business Name): WOODLAWN CARE AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S WOODLAWN BLVD
WICHITA KS
67218-4728
US

IV. Provider business mailing address

1123 MCDONALD AVE
BROOKLYN NY
11230-3320
US

V. Phone/Fax

Practice location:
  • Phone: 316-691-9999
  • Fax:
Mailing address:
  • Phone: 845-202-9844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GREENFIELD
Title or Position: MANAGER
Credential:
Phone: 845-202-9844