Basic Information
| Provider Information | |||||||||
| NPI: | 1548581671 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WESLEY COURT METHODIST RETIREMENT COMMUNITY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 VILLAGE DR STE 310 | ||||||||
| Address2: | |||||||||
| City: | ABILENE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 796068244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3254375884 | ||||||||
| FaxNumber: | 3254375901 | ||||||||
| Practice Location | |||||||||
| Address1: | 2617 ANTILLEY RD | ||||||||
| Address2: | |||||||||
| City: | ABILENE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 796065109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3254371184 | ||||||||
| FaxNumber: | 3254371185 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2010 | ||||||||
| LastUpdateDate: | 06/11/2010 | ||||||||
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| AuthorizedOfficialLastName: | DOTTIN | ||||||||
| AuthorizedOfficialFirstName: | ANGELA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF REHAB OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 3254375884 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SEARS METHODIST RETIREMENT SYSTEM | ||||||||
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| AuthorizedOfficialCredential: | OT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | 102003 | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.