Organization
WOODS MANOR
Active
Parent organization
WOODS MANOR LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
WOODS MANOR LLC
Authorized official
MS. TAMMY WOODS (CEO)
(856) 203-4195
Entity
Organization
Contact information
Practice address
1505 S ACADEMY ST, GLASSBORO, NJ 08028-3368
(856) 244-8072
(856) 537-5769
Mailing address
409 STEEPLECHASE CT, DEPTFORD, NJ 08096-6810
(856) 244-8072
(856) 537-5769
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0568694
—
NJ
Enumeration date
12/22/2019
Last updated
07/31/2020
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