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Organization

WESLEY HOUSE ALF

Active
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Organization

WESLEY HOUSE ALF

Active
Parent organization
WESLEY HOUSE #2 ALF
Organization subpart
Yes

Provider details

NPI number
Legal business name
WESLEY HOUSE #2 ALF
Authorized official
MRS. LOLA JEYDE OWNER ADMIN (OWNER ADMIN)
(813) 469-4496
Entity
Organization

Contact information

Practice address
1146 TIMBER TRACE DR, WESLEY CHAPEL, FL 33543
(813) 907-5565
(813) 907-5565
Mailing address
1146 TIMBER TRACE DR, WESLEY CHAPEL, FL 33543
(813) 907-5565
(813) 907-5565

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL10654
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140033900
MEDICARE
FL
05
140033900
FL
01
6817432
MEDICARE
FL
01
681743296
MEDICARE
FL
Enumeration date
03/07/2008
Last updated
03/07/2008
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