Healthcare Provider Details

I. General information

NPI: 1700524097
Provider Name (Legal Business Name): WELLSPRING ADULT DAY SERVICES CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 HOES LN
PISCATAWAY NJ
08854-4115
US

IV. Provider business mailing address

5308 13TH AVE # 464
BROOKLYN NY
11219-5198
US

V. Phone/Fax

Practice location:
  • Phone: 917-588-2081
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: USHER SCHWARTZ
Title or Position: CEO
Credential:
Phone: 917-588-2081