WOODLAWN LP NPI 1679565709

NPI Information

NPI: 1679565709
Provider Name: WOODLAWN LP

Doing Business As: PROVIDENCE HOUSE

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

Address:
405 N 20TH ST
GUTHRIE, OK
ZIP 73044
Phone: (405) 282-1517
Get Directions

WOODLAWN LP is an intermediate care facility mentally retarded in Guthrie, OK. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. WOODLAWN LP NPI is 1679565709. The provider is registered as an organization entity type.
The provider Is Doing Business As Providence House.

The provider's business location address is:

405 N 20TH ST
GUTHRIE, OK
ZIP 73044-103
Phone: (405) 282-1517
Fax: (405) 282-9007

The provider's authorized official is Greg Machtolff .
The authorized official title is Manager and has the following contact phone number (405) 282-2600.

The CLIA number assigned to this NPI record is 37D0999333 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/16/2005 and was last updated on 9/8/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		NH4208	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100771000A	MEDICAID	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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