Healthcare Provider Details

I. General information

NPI: 1184601403
Provider Name (Legal Business Name): WESLEY RETIREMENT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 09/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 N E ST
INDIANOLA IA
50125-3276
US

IV. Provider business mailing address

1203 N E ST
INDIANOLA IA
50125-3276
US

V. Phone/Fax

Practice location:
  • Phone: 515-961-7458
  • Fax: 515-961-0898
Mailing address:
  • Phone: 515-961-7458
  • Fax: 515-961-0898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number910708
License Number StateIA

VIII. Authorized Official

Name: MR. CAL SHELANGOSKI
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 515-271-6896