Provider Demographics
NPI:1013458124
Name:WESLEY SENIOR SOLUTIONS
Entity Type:Organization
Organization Name:WESLEY SENIOR SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HCBS
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:WELDEN-PINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-584-1200
Mailing Address - Street 1:77 VAN DAM ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2056
Mailing Address - Country:US
Mailing Address - Phone:518-584-1200
Mailing Address - Fax:
Practice Address - Street 1:77 VAN DAM ST STE 4
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2056
Practice Address - Country:US
Practice Address - Phone:518-584-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2509L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY123456789Medicaid