Provider Demographics
NPI:1003414061
Name:WESLEY PLACE ON HONEYSUCKLE SCALF
Entity Type:Organization
Organization Name:WESLEY PLACE ON HONEYSUCKLE SCALF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP & DIR, ADMINISTRATIVE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:LAWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-951-2442
Mailing Address - Street 1:1520 COOPER HILL RD
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2303
Mailing Address - Country:US
Mailing Address - Phone:205-951-2442
Mailing Address - Fax:
Practice Address - Street 1:718 HONEYSUCKLE RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1104
Practice Address - Country:US
Practice Address - Phone:334-792-0921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST HOME FOR THE AGING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility