NPIMap

Organization Active NPI

Wesley House Alf

  • Assisted Living Facility
  • Wesley Chapel, FL
National Provider Identifier
1295905016
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10654 Issued in FL
Legal business name
WESLEY HOUSE ALF
Practice address
1146 Timber Trace Dr
Wesley Chapel, FL 33543
Phone
(813) 907-5565
Fax
(813) 907-5565
NPI assigned
Mar 7, 2008
Organization subpart
Yes
Parent organization
WESLEY HOUSE #2 ALFAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lola Jeyde, OWNER ADMIN
Title
Owner Admin
Phone
(813) 469-4496

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL10654 FL Primary

Addresses

Primary practice location

1146 Timber Trace Dr
Wesley Chapel, FL 33543

Mailing address

1146 Timber Trace Dr
Wesley Chapel, FL 33543
Phone (813) 907-5565

Other identifiers 4

IdentifierTypeStateIssuer
140033900MedicaidFL
6817432OtherFLMEDICARE
681743296OtherFLMEDICARE
140033900OtherFLMEDICARE

National Provider Directory

National Provider Directory
Tax ID family
Wesley House Aif3 organizations share this tax ID, including this one
Part of
Wesley House Aif

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1295905016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 TIMBER TRACE DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "33543",
            "telephone_number": "813-907-5565",
            "fax_number": "813-907-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 TIMBER TRACE DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "33543",
            "telephone_number": "813-907-5565",
            "fax_number": "813-907-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY HOUSE ALF",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESLEY HOUSE #2 ALF",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "JEYDE",
        "authorized_official_first_name": "LOLA",
        "authorized_official_title_or_position": "OWNER ADMIN",
        "authorized_official_telephone_number": "813-469-4496",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OWNER ADMIN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140033900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "6817432",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "681743296",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "140033900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.