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WOOD LANE RESIDENTIAL SERVICES
NPI 1316568603
Intermediate Care Facility, Intellectual Disabilities in Portage, OH

Active since April 28, 2020
351 W MAIN ST, PORTAGE, OH 43451(419) 686-6951 Get Directions Write a Review

NPPES record last updated: April 28, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Table of Contents

  1. NPI Profile Information
  2. Primary Taxonomy
  3. Authorized Official
  4. Frequently Asked Questions
  • Organization
  • Intermediate Care Facility, Intellectual...

About WOOD LANE RESIDENTIAL SERVICES

This page provides the complete NPI Profile along with additional information for Wood Lane Residential Services, a provider established in Portage, Ohio operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1316568603 assigned on April 2020. The practitioner's primary taxonomy code is 315P00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Jessica Blakely (Ceo)

NPI
1316568603 Verify this NPI
Provider Name
WOOD LANE RESIDENTIAL SERVICES
Entity Type
Organization
Location Address
351 W MAIN ST PORTAGE, OH 43451
Location Phone
(419) 686-6951
Mailing Address
545 PEARL ST BOWLING GREEN, OH 43402
Mailing Phone
(419) 353-9577
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-28-2020
Last Update Date
04-28-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Intermediate Care Facility, Intellectual Disabilities

Taxonomy Code
315P00000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
An intermediate care facility providing services for individuals with intellectual disabilities.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JESSICA BLAKELY

Authorized Official Title
CEO
Authorized Official Phone
(419) 353-9577

Reviews for WOOD LANE RESIDENTIAL SERVICES

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Frequently Asked Questions

What is WOOD LANE RESIDENTIAL SERVICES's NPI number?

The NPI number assigned to this healthcare provider is 1316568603, enumerated as an "organization" on April 28, 2020.

Where is the provider located?

The provider is located at 351 W MAIN ST PORTAGE, OH 43451 and the phone number is (419) 686-6951.

What is the provider's specialty?

Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.