Healthcare Provider Details

I. General information

NPI: 1619754884
Provider Name (Legal Business Name): WOODS COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 09/12/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 BEECHTREE RD
LEVITTOWN PA
19057-3012
US

IV. Provider business mailing address

42 BEECHTREE RD
LEVITTOWN PA
19057-3012
US

V. Phone/Fax

Practice location:
  • Phone: 215-750-4285
  • Fax:
Mailing address:
  • Phone: 215-750-4285
  • 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 Code103T00000X
TaxonomyPsychologist
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
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MONICA MOSER
Title or Position: CEO
Credential:
Phone: 215-750-4285