Provider Demographics
NPI:1942897780
Name:WILEY HOMES INCORPORATED
Entity Type:Organization
Organization Name:WILEY HOMES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-686-1130
Mailing Address - Street 1:5250 RENWYCK DR STE D
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-5964
Mailing Address - Country:US
Mailing Address - Phone:567-686-1130
Mailing Address - Fax:419-725-1701
Practice Address - Street 1:5250 RENWYCK DR STE D
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-5964
Practice Address - Country:US
Practice Address - Phone:567-686-1130
Practice Address - Fax:419-725-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services