Organization
WESLEY VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLY L WARD LWHA (CEO/ ADMINISTRATOR)
(309) 837-7500
Entity
Organization
Contact information
Practice address
1200 E GRANT ST, MACOMB, IL 61455-3428
(309) 833-2123
(309) 837-7500
Mailing address
1200 E GRANT ST, MACOMB, IL 61455-3428
(309) 833-2123
(309) 837-7500
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
0022350
IL
314000000X
Skilled Nursing Facility
Primary
0022350
IL
Other
Enumeration date
08/30/2006
Last updated
06/10/2024
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