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General NPI Number Information
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NPI Number | 1013280171
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Entity Type | Organization
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Legal Business Name | WESLEY HOUSE FAMILY SERVICES
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Dates
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Enumeration Date | 02/20/2012
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Last Update Date | 02/20/2012
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Provider Practice Location Address
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Address Line | 3114 FLAGLER AVE
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City | KEY WEST
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State | FL
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Zip | 33040-4602
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Country | US
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Telephone | 305-809-5000
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Fax | 305-809-5010
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Provider Business Mailing Address
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Address Line | 1304 TRUMAN AVE
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City | KEY WEST
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State | FL
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Zip | 33040-7268
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Country | US
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Telephone | 305-809-5000
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Fax | 305-809-5010
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Authorized Official
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Title or Position | CEO
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Name | DOUG BLOMBERG
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Credential |
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Telephone | 305-809-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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