WESLEY COMMUNITY CENTER INC (NPI# 1013547686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013547686 |
| Entity Type | Organization |
| Organization Name | WESLEY COMMUNITY CENTER INC |
| Practice Address |
1510 S 19th Dr Ste 100 Phoenix AZ 85009-6540 |
| Mailing Address |
1300 S 10th St Phoenix AZ 85034-4516 |
| Practice Telephone | 6023689896 |
| Mailing Telephone | 6023689603 |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |
| Authorized Official Name | BLAINE BANDI (CEO) |
| Authorized Official Telephone | 6023689616 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396910436 | Wesley Community Center Inc | Clinic/Center | 1300 S 10th St, Phoenix, AZ 85034-4516 | 2008-04-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WESLEY COMMUNITY CENTER INC | 1300 S 10th St, Phoenix, AZ 85034-4516 |
| Street Address |
1510 S 19TH DR STE 100 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85009-6540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220065 | Ashley Medeiros | Specialist/Technologist | 2926 E. Encanto Blvd., Phoenix, AZ 85009 | 2020-09-16 |
| 1326252909 | Raul Herreras | Speech-Language Pathologist | 3101 W. Mcdowell Road, Phoenix, AZ 85009 | 2007-05-10 |
| 1295956779 | Gerardo Gaerlan Gregorio | Internal Medicine | 3250 W. Lower Buckeye Road, Phoenix, AZ 85009 | 2007-05-01 |
| 1316060338 | Eve Ronnie Davidson | Registered Nurse | 3333wroosevelt, Phoenix, AZ 85009 | 2007-04-06 |
| 1679693808 | Paul Thomas Lorentsen | Internal Medicine | 1929 W. Fillmore St, Bldg C, The Neighborhood Christian Clinic, Phoenix, AZ 85009 | 2007-03-30 |
| 1134246655 | Audrea J Chambers-pryce | Registered Nurse | 3715 W Roosevelt, Phx, AZ 85009 | 2007-03-22 |
| 1053437582 | Monique Marie Knepper | Licensed Practical Nurse | 3025 W Mc Dowell Rd, Phoenix, AZ 85009 | 2007-03-22 |
| 1245356054 | Lena Rose Felder | Speech-Language Pathologist | 3348 W. Mcdowell Rd., Phoenix, AZ 85009 | 2007-03-22 |
| 1508900036 | Walter M Wood | Psychologist | 3348 W Mcdowell Road, Phoenix, AZ 85009 | 2007-02-17 |
| 1194869982 | Maureen Brukardt | Registered Nurse | 3449 N 39th Ave, Phx, AZ 85009 | 2007-02-16 |
| Find all providers in zip 85009 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.