Provider Demographics
NPI:1710368477
Name:WOODWAY HEALTHCARE, INC.
Entity type:Organization
Organization Name:WOODWAY HEALTHCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-487-9500
Mailing Address - Street 1:27101 PUERTA REAL
Mailing Address - Street 2:SUITE 450
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8518
Mailing Address - Country:US
Mailing Address - Phone:254-420-0056
Mailing Address - Fax:254-420-0058
Practice Address - Street 1:27101 PUERTA REAL
Practice Address - Street 2:SUITE 450
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8518
Practice Address - Country:US
Practice Address - Phone:254-420-0056
Practice Address - Fax:254-420-0058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310400000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility