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
349 W MAIN ST., PORTAGE, OH 43451
(419) 353-9577
Mailing address
545 PEARL ST, BOWLING GREEN, OH 43402-2731
(419) 353-9577
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
OH
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2585751
—
OH
05
—
36G087
—
OH
05
—
36G260
—
OH
05
—
36G261
—
OH
05
—
36G344
—
OH
05
—
36G345
—
OH
05
—
36G381
—
OH
05
—
36G474
—
OH
05
—
36G475
—
OH
Enumeration date
09/28/2006
Last updated
07/21/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us