Provider Demographics
NPI:1114088168
Name:WESLEY COMMUNITY SERVICES, INC.
Entity Type:Organization
Organization Name:WESLEY COMMUNITY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-699-3367
Mailing Address - Street 1:944 18TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-1152
Mailing Address - Country:US
Mailing Address - Phone:515-288-3334
Mailing Address - Fax:
Practice Address - Street 1:3206 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-3820
Practice Address - Country:US
Practice Address - Phone:515-288-3334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESLEYLIFE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-13
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0714170Medicaid
IA0481952Medicaid
IA0105692Medicaid