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Organization
WOOD LANE RESIDENTIAL SERVICES, INC.
Active
Organization
WOOD LANE RESIDENTIAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA BLAKELY (CHIEF EXECUTIVE OFFICER)
(419) 353-9577
Entity
Organization
Contact information
Practice address
1009 KLOTZ RD, BOWLING GREEN, OH 43402-4820
(419) 353-9577
Mailing address
545 PEARL ST, BOWLING GREEN, OH 43402-2784
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
32699
OH
Other
Enumeration date
06/07/2017
Last updated
06/07/2017
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