Provider Demographics
NPI:1518945393
Name:WESSELL GENERATIONS, INC.
Entity Type:Organization
Organization Name:WESSELL GENERATIONS, INC.
Other - Org Name:WELCOME NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HERRON
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:440-775-1491
Mailing Address - Street 1:417 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44074-1749
Mailing Address - Country:US
Mailing Address - Phone:440-775-1491
Mailing Address - Fax:440-775-9964
Practice Address - Street 1:417 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074-1749
Practice Address - Country:US
Practice Address - Phone:440-775-1491
Practice Address - Fax:440-775-9964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0436N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2282453Medicaid
OH2282453Medicaid