Organization
WOODLAND MANOR NURSING, LLC
Active
Other names
Eaglewood Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
BOYD P GENTRY (PRESIDENT & CEO)
(937) 964-8974
Entity
Organization
Contact information
Practice address
2000 VILLA RD, SPRINGFIELD, OH 45503-1761
(937) 399-7195
(937) 399-1474
Mailing address
2000 VILLA RD, SPRINGFIELD, OH 45503-1761
(937) 399-7195
(937) 399-1474
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0628566
—
OH
Enumeration date
12/20/2011
Last updated
12/20/2011
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