- Enrollment id
- O20051130000225
- Enrollment state
- TX
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1376763821
- Multiple npi flag
- N
- Ccn
- 679528
- Associate id
- 1052331410
- Organization name
- WESLEY HOME HEALTH SERVICES INC.
- Incorporation date
- 2005-09-20
- Incorporation state
- TX
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 10701 CORPORATE DR
- Address line 2
- STE 332
- City
- STAFFORD
- State
- TX
- Zip code
- 774774017