Provider Demographics
NPI:1326178039
Name:WESLEY HEALTH SYSTEM LLC
Entity Type:Organization
Organization Name:WESLEY HEALTH SYSTEM LLC
Other - Org Name:WESLEY MEDICAL CENTER EMPLOYEE ASSISTANCE PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:T
Authorized Official - Last Name:SEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-268-8101
Mailing Address - Street 1:239 METHODIST BLVD
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402
Mailing Address - Country:US
Mailing Address - Phone:601-268-5026
Mailing Address - Fax:601-268-8645
Practice Address - Street 1:239 METHODIST BLVD
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402
Practice Address - Country:US
Practice Address - Phone:601-268-5026
Practice Address - Fax:601-268-8645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1216B101YP2500X
MSC03761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty