WOODLAND VILLAGE LLC (NPI# 1417319021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417319021 |
| Entity Type | Organization |
| Organization Name | WOODLAND VILLAGE LLC |
| Other Organization Name | FAWN RIDGE SENIOR LIVING |
| Practice Address |
2902 Tibbits Ave Troy NY 12180-7077 |
| Practice Telephone | 5182732040 |
| Mailing Telephone | 5182732040 |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |
| Authorized Official Name | MR. NEIL ZELMAN (COO) |
| Authorized Official Telephone | 8453577387 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 600-F-248 | NY | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Fawn Ridge Senior Living | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | WOODLAND VILLAGE LLC | 12 College Road, Monsey, Ny 10952 |
| Street Address |
2902 TIBBITS AVE |
| City | TROY |
| State | NY |
| Zip Code | 12180-7077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194331348 | Carina Ross | Occupational Therapist | 2902 Tibbits Ave, Troy, NY 12180-7077 | 2020-09-22 |
| 1598325771 | The Eliot At Troy LLC | Home Health | 2902 Tibbits Ave, Troy, NY 12180-7077 | 2019-06-19 |
| 1922581347 | Kara Eileen Huber | Physical Therapist | 2902 Tibbits Ave, Troy, NY 12180-7077 | 2018-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528616232 | Gwendolyn Eve Guarino | Massage Therapist | Lux, 207 River St, Troy, NY 12180 | 2019-08-27 |
| 1568020857 | Shelby Mara Quintal | Counselor | 7 Collins Ave, Troy, NY 12180 | 2019-05-31 |
| 1881179646 | St. Peter's Health Partners Medical Associates, P.C. | Family Medicine | 2109 15th Street, Troy, NY 12180 | 2018-09-27 |
| 1104354315 | Karen Lynm Vincent | Licensed Practical Nurse | 830 Hoosick Rd Apt 1, Troy, NY 12180 | 2017-06-01 |
| 1740728013 | Upstate Physician Services, PC | Specialist | 2001 5th Avenue, Suite 110, Troy, NY 12180 | 2017-02-07 |
| 1205373263 | Tsu Han Poh | Pharmacist | 204 Washington Street, Apt C1, Troy, NY 12180 | 2017-01-27 |
| 1053760546 | Linda Pierre | Religious Nonmedical Nursing Personnel | 1680 Tibbits Ave, Troy, NY 12180 | 2016-06-06 |
| 1518312925 | Matthew Pittelli | Student in an Organized Health Care Education/Training Program | 83 Lockrow Rd, Troy, NY 12180 | 2016-05-04 |
| 1780045765 | Tara Michelle Miller | Hearing Instrument Specialist | 2000 6th Avenue, Troy Towers, Bldg. B, 1st Floor, Troy, NY 12180 | 2016-03-17 |
| 1326410937 | Seton Health System, Inc. | Physician Assistant | 1401 Massachusetts Avenue, Troy Internal Medicine, Troy, NY 12180 | 2015-10-22 |
| Find all providers in zip 12180 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295341956 | Comfort Home of Bloomfield Inc | Assisted Living Facility | 6372 Tutbury Ln, Troy, MI 48098-2151 | 2020-09-18 |
| 1447892252 | Szr Troy Assisted Living, LLC | Assisted Living Facility | 6870 Crooks Rd, Troy, MI 48098-1704 | 2019-10-14 |
| 1902460728 | Sl Troy, LLC | Assisted Living Facility | 2900 Corporate Dr, Troy, OH 45373-2057 | 2019-04-26 |
| 1184868523 | Troy Residential, LLC | Assisted Living Facility | 159 Professional Parkway, Troy, MO 63379 | 2009-04-29 |
| 1568659878 | Assisted Living Concepts Inc | Assisted Living Facility | 2900 Corporate Drive, Troy, OH 45373 | 2007-10-01 |
| 1912114869 | Troy House Residential Care Inc. | Assisted Living Facility | 350 Cap Au Gris St, Troy, MO 63379-1761 | 2007-05-17 |
| 1891865432 | Eden Park Health Services, Inc | Assisted Living Facility | 2405 15th St, Troy, NY 12180-1702 | 2006-11-09 |
| 1629625686 | Snh Lincoln Tenant LLC | Assisted Living Facility | 39 Dorothy Dr, Troy, IL 62294-1389 | 2019-08-23 |
| 1346786639 | Troy Crossings LLC | Assisted Living Facility | 2405 15th St, Troy, NY 12180-1702 | 2017-01-11 |
| 1083006720 | Elderhaus Inn #19, LLC | Assisted Living Facility | 125 Anna Ave, Troy, MO 63379-2402 | 2015-03-03 |
| Find all providers in TROY | ||||
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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.