Healthcare Provider Details
I. General information
NPI: 1124729272
Provider Name (Legal Business Name): WOODS COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/15/2023
Last Update Date: 03/15/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18 TANGLEWOOD LN
LEVITTOWN PA
19054-2206
US
IV. Provider business mailing address
40 MARTIN GROSS DR
LANGHORNE PA
19047-1616
US
V. Phone/Fax
- Phone: 215-750-4285
- Fax:
- Phone: 215-750-4285
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | NULL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
TINE
HANSEN-TURTON
Title or Position: CEO & PRESIDENT
Credential:
Phone: 215-750-4285