Healthcare Provider Details

I. General information

NPI: 1619819810
Provider Name (Legal Business Name): WOODLAND HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1347 E VALLEY WATER MILL RD
SPRINGFIELD MO
65803-3739
US

IV. Provider business mailing address

477 N LINDBERGH BLVD STE 310
SAINT LOUIS MO
63141-7856
US

V. Phone/Fax

Practice location:
  • Phone: 417-833-1220
  • Fax:
Mailing address:
  • Phone: 314-631-3000
  • 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: JUDAH BIENSTOCK
Title or Position: CEO
Credential:
Phone: 314-631-3000