Organization
JENNSWOOD ENTERPRISE LLC
Active
Organization
JENNSWOOD ENTERPRISE LLC
Active
Other names
Woodhaven Behavioral LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SUE WOOD (CEO)
(765) 586-4764
Entity
Organization
Contact information
Practice address
100 EXECUTIVE DR STE D, LAFAYETTE, IN 47905-4863
(765) 537-3880
(765) 548-4332
Mailing address
7611 S 350 E, LAFAYETTE, IN 47909-8112
(765) 586-4764
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
06/03/2024
Last updated
03/16/2025
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