Provider Demographics
NPI:1437555463
Name:WESLEY PARTNERS SENIOR LIVING LLC
Entity Type:Organization
Organization Name:WESLEY PARTNERS SENIOR LIVING LLC
Other - Org Name:WESLEY HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:G
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-537-4522
Mailing Address - Street 1:PO BOX 612
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:75457-0612
Mailing Address - Country:US
Mailing Address - Phone:903-537-4522
Mailing Address - Fax:903-270-6227
Practice Address - Street 1:110 OUTLET DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:TX
Practice Address - Zip Code:76645-2752
Practice Address - Country:US
Practice Address - Phone:254-582-0030
Practice Address - Fax:254-580-1608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310400000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility