- Enrollment id
- O20250303001651
- Enrollment state
- NH
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1265250245
- Multiple npi flag
- N
- Ccn
- 305097
- Associate id
- 0042731424
- Organization name
- WOODLAWN HEALTHCARE CENTER LLC
- Doing business as name
- CORRECT TAX ID 99-0572643
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- WOODLAWN HEALTHCARE CENTER LLC
- Address line 1
- 84 PINE ST
- City
- NEWPORT
- State
- NH
- Zip code
- 037732005