Healthcare Provider Details

I. General information

NPI: 1508838582
Provider Name (Legal Business Name): WOODLAND CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 03/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3086 STATE ROUTE 160
GALLIPOLIS OH
45631-8409
US

IV. Provider business mailing address

3086 STATE ROUTE 160
GALLIPOLIS OH
45631-8409
US

V. Phone/Fax

Practice location:
  • Phone: 740-446-5500
  • Fax: 740-441-4402
Mailing address:
  • Phone: 740-446-5500
  • Fax: 740-441-4402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID A TENER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 740-446-5500