MEDICARE: THE WOODLANDS RECOVERY, LLC DBA THE WOODLANDS GROVE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1427927904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WOODLANDS RECOVERY, LLC DBA THE WOODLANDS GROVE

Provider Business Mailing Address
First Line	:	15145 LINCOLN HWY
Second Line	:
City	:	VAN WERT
State	:	OH
Zip	:	45891-9619
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15145 LINCOLN HWY
Second Line	:
City	:	VAN WERT
State	:	OH
Zip	:	45891-9619
Country	:	US
Telephone Number	:	614-378-5456
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	JOHN DAILY
Credential	:
Telephone Number	:	419-605-0600

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	01/21/2026

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