MEDICARE: WESLEYAN VILLAGE LLC

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
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528065737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESLEYAN VILLAGE LLC

Provider Business Mailing Address
First Line	:	807 WEST AVE
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-5898
Country	:	US
Telephone Number	:	440-284-9000
Fax Number	:	440-322-6954

Provider Business Practice Location Address
First Line	:	807 WEST AVE
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-5898
Country	:	US
Telephone Number	:	440-284-9000
Fax Number	:	440-284-9636

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELAN RUGGILL
Credential	:
Telephone Number	:	734-222-5275

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	12/11/2025

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Directions to “WESLEYAN VILLAGE LLC ” Practice Location

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