Wesley Village

NPI 1558471714 - Nursing Facility/Intermediate Care Facility - 313M00000X

NPI Details
NPI 1558471714
Enumeration Date 08/30/2006
Last Updated 04/04/2014
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name SHELLY L SHELLY
Position CEO/ ADMINISTRATOR
Phone (309) 833-2123
Fax (309) 837-7500
Practice Location
1200 E GRANT ST
MACOMB IL, 61455-3428, US
Phone (309) 833-2123
Fax (309) 837-7500
Business Location
1200 E GRANT ST
MACOMB IL, 61455-3428, US
Phone (309) 833-2123
Fax (309) 837-7500
Toxanomy
Taxonomy Code 313M00000X
License State Illinois
License Number 0022350
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According to our database, Wesley Village NPI is 1558471714, taxonomy code is 313M00000X and license number is 0022350, license state is located at Illinois. Wesley Village physically located at 1200 E Grant St, Macomb IL, 61455-3428. NPI Number 1033115704 has the healthcare provider type.

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1558471714 NPI number is provided on an as is basis without warranty of any kind. 1558471714 is maintained by the National Plan & Provider Enumeration System. The contents of Wesley Village are for informational purposes only.