Organization
WESLEY MANOR NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK STEPHENS (V.P. ADMIN. / CFO)
(502) 969-3277
Entity
Organization
Contact information
Practice address
5012 E MANSLICK RD, LOUISVILLE, KY 40219-5165
(502) 969-3277
(502) 969-3259
Mailing address
5012 E MANSLICK RD, LOUISVILLE, KY 40219-5165
(502) 969-3277
(502) 969-3259
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
100230
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000054578
ANTHEM BCBS
KY
Enumeration date
05/06/2008
Last updated
05/06/2008
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