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General NPI Number Information
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NPI Number | 1518628429
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Entity Type | Organization
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Legal Business Name | WELL TREVI WH SNF LLC
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Dates
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Enumeration Date | 01/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 5100 FILLMORE AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22311-5069
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Country | US
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Telephone | 703-845-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 DORR ST
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City | TOLEDO
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State | OH
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Zip | 43615-4040
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | MARY ELLEN PISANELLI
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Credential |
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Telephone | 419-247-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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