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General NPI Number Information
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NPI Number | 1649840638
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Entity Type | Organization
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Legal Business Name | WESLEY HOMES HOSPICE, LLC
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 06/30/2021
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Provider Practice Location Address
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Address Line | 18000 72ND AVE S STE 217
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City | KENT
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State | WA
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Zip | 98032-1035
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Country | US
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Telephone | 206-870-1118
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Fax | 206-870-4165
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Provider Business Mailing Address
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Address Line | 18000 72ND AVE S STE 217
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City | KENT
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State | WA
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Zip | 98032-1035
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Country | US
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Telephone | 206-870-1118
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Fax | 206-870-4165
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MELINDA MOORE
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Credential |
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Telephone | 206-870-1118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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