WOODSIDE HEALTHCARE (NPI# 1356796668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356796668 |
| Entity Type | Organization |
| Organization Name | WOODSIDE HEALTHCARE |
| Practice Address |
4309 Kenwood Dr Woodbridge VA 22193-5282 |
| Mailing Address |
1010 Southern Night Ln Gaithersburg MD 20879-3268 |
| Practice Telephone | 2407500045 |
| Mailing Telephone | 2407500045 |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2016-04-25 |
| Authorized Official Name | ISAIAH A TEASLEY (CEO) |
| Authorized Official Telephone | 2407500045 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 08041139 | VA | Residential Treatment Facilities |
| Street Address |
4309 KENWOOD DR |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22193-5282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972981090 | Lifeline Home Health Inc | Community/Behavioral Health | 4309 Kenwood Dr, Woodbridge, VA 22193 | 2015-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083111702 | Bethiana Magallanes White | Speech-Language Pathologist | 14450 Brook Dr, Woodbridge, VA 22193 | 2018-04-09 |
| 1982111449 | Frances Davis | Social Worker | 4196 Merchant Plaza Apt 632, Woodbridge, VA 22193 | 2018-01-05 |
| 1427421627 | Woodbridge Therapy Group LLC | Counselor | 12721 Darby Brooke Ct., Suite 102, Woodbridge, VA 22193 | 2015-11-10 |
| 1588056139 | Lifelong Good Health LLC | Clinic/Center | 5721 Rhode Isalnd Drive, Woodbridge, VA 22193 | 2015-02-19 |
| 1639560378 | Tara Devi Smith | Psychologist | 13855 Hedgewood Drive, #245, Woodbridge, VA 22193 | 2015-02-17 |
| 1710396114 | Allanna Harrison | Speech-Language Pathologist | 15792 Beau Ridge Dr., Woodbridge, VA 22193 | 2014-08-11 |
| 1659788909 | Lifelong Good Health | Clinic/Center | 5721 Rhode Island Dr, Woodbridge, VA 22193 | 2014-07-18 |
| 1952731960 | Corrieann Marie Avila | Social Worker | 12721 Darby Brooke Court, Suite 102, Woodbridge, VA 22193 | 2013-11-13 |
| 1972881019 | Ockhee Jung | Acupuncturist | 14174 Rizdon Ct, Woodbridge, VA 22193 | 2011-07-22 |
| 1619263092 | Long Healthcare | Adult Companion | 12998 Taxi Drive, Woodbridge, VA 22193 | 2011-06-23 |
| Find all providers in zip 22193 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689223224 | Eveready Residential Support Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 14240 Spriggs Rd, Woodbridge, VA 22193-3610 | 2019-09-06 |
| 1922657618 | Comfort Group Home, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 13397 Nationville Ln, Woodbridge, VA 22193-4152 | 2019-09-05 |
| 1144875337 | Bethel Residential Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1966 Powells Landing Cir, Woodbridge, VA 22191-4440 | 2019-08-05 |
| 1982263968 | All In All Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4707 Lehigh Ct, Woodbridge, VA 22193-4635 | 2019-06-12 |
| 1891257416 | Avid Care Services, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 15110 Kentshire Dr, Woodbridge, VA 22191-4053 | 2019-04-02 |
| 1871058404 | Peaceful Living Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6221 Oscar Ct, Woodbridge, VA 22193-7024 | 2019-02-07 |
| 1285957761 | Provident Arc LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 17300 River Ridge Blvd, Suite 301, Woodbridge, VA 22191-5167 | 2010-03-11 |
| 1588754519 | Insight, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 13505 Hillendale Dr, Woodbridge, VA 22193-4716 | 2006-10-13 |
| 1316569338 | Angels Residential Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 12770 Ripple Creek Ct Apt 2314, Woodbridge, VA 22192-6562 | 2020-05-13 |
| 1063066470 | Pennreach | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 114, Woodbridge, NJ 17001-0850 | 2019-07-25 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22193 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.