Provider Demographics
NPI:1548581671
Name:WESLEY COURT METHODIST RETIREMENT COMMUNITY
Entity Type:Organization
Organization Name:WESLEY COURT METHODIST RETIREMENT COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REHAB OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOTTIN
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:325-437-5884
Mailing Address - Street 1:1 VILLAGE DR STE 310
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-8244
Mailing Address - Country:US
Mailing Address - Phone:325-437-5884
Mailing Address - Fax:325-437-5901
Practice Address - Street 1:2617 ANTILLEY RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5109
Practice Address - Country:US
Practice Address - Phone:325-437-1184
Practice Address - Fax:325-437-1185
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEARS METHODIST RETIREMENT SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102003261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation