Provider Demographics
NPI:1710977459
Name:WESLEY HEALTH CARE CENTER, INC.
Entity Type:Organization
Organization Name:WESLEY HEALTH CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:AMATO
Authorized Official - Suffix:III
Authorized Official - Credentials:CPA, MBA
Authorized Official - Phone:518-587-3600
Mailing Address - Street 1:131 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-1346
Mailing Address - Country:US
Mailing Address - Phone:518-587-3600
Mailing Address - Fax:518-581-5973
Practice Address - Street 1:131 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866
Practice Address - Country:US
Practice Address - Phone:518-587-3600
Practice Address - Fax:518-581-5973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4501301N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03175344Medicaid
NY00314250Medicaid
NY00314250Medicaid