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NPI Code Detail

MEDICARE: SALENA WILSON

MEDICARE:   SALENA  WILSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health Aide401846720416OH

General Provider Information

NPI Number : 1629817259
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALENA WILSON
Provider Business Mailing Address
First Line : 46 SHOPPING PLZ UNIT 5021
Second Line :
City : CHAGRIN FALLS
State : OH
Zip : 44022-3022
Country : US
Telephone Number : 216-785-4155
Fax Number :
Provider Business Practice Location Address
First Line : 23018 EMERY RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44128-5135
Country : US
Telephone Number : 216-785-4511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2024
Last Update Date : 05/22/2024

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Directions to “ SALENA WILSON ” Practice Location

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