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General NPI Number Information
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NPI Number | 1871224246
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Entity Type | Organization
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Legal Business Name | WOODEN GROUP HOME HELP
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 10/03/2022
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Provider Practice Location Address
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Address Line | 22800 CIVIC CENTER DR APT 103-A
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City | SOUTHFIELD
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State | MI
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Zip | 48033-7140
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Country | US
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Telephone | 248-763-7101
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Fax |
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Provider Business Mailing Address
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Address Line | 22800 CIVIC CENTER DR APT 103-A
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City | SOUTHFIELD
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State | MI
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Zip | 48033-7140
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Country | US
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Telephone | 248-763-7101
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAWON WOODEN
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Credential |
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Telephone | 248-763-7101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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