MEDICARE: WESLEY PARTNERS, LTD.

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	310400000X	Assisted Living Facility	118003	TX

General Provider Information

NPI Number	:	1861532863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESLEY PARTNERS, LTD.

Provider Business Mailing Address
First Line	:	1102 S WILLIAM ST
Second Line	:
City	:	ATLANTA
State	:	TX
Zip	:	75551-3281
Country	:	US
Telephone Number	:	903-796-6300
Fax Number	:	903-796-2275

Provider Business Practice Location Address
First Line	:	1102 S WILLIAM ST
Second Line	:
City	:	ATLANTA
State	:	TX
Zip	:	75551-3281
Country	:	US
Telephone Number	:	903-796-6300
Fax Number	:	903-796-2275

Authorized Official
Title or Position	:	PRESIDENT(WESLEYHOUSE, INC.-GNPTNR)
Name	:	MIKE JORDAN
Credential	:
Telephone Number	:	903-537-4116

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	08/22/2020

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