Healthcare Provider Details

I. General information

NPI: 1154067551
Provider Name (Legal Business Name): WOODS COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 LAUREL LN
LEVITTOWN PA
19054-3920
US

IV. Provider business mailing address

40 MARTIN GROSS DR
LANGHORNE PA
19047-1616
US

V. Phone/Fax

Practice location:
  • Phone: 215-750-4000
  • Fax:
Mailing address:
  • Phone: 215-750-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MARY ELLEN ANGELINI
Title or Position: AVP SPECIAL PROJECTS
Credential:
Phone: 215-750-4285