Healthcare Provider Details

I. General information

NPI: 1144220393
Provider Name (Legal Business Name): SL WELLSPRING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W GALBRAITH RD
CINCINNATI OH
45215-5223
US

IV. Provider business mailing address

230 W GALBRAITH RD
CINCINNATI OH
45215-5223
US

V. Phone/Fax

Practice location:
  • Phone: 513-948-2308
  • Fax:
Mailing address:
  • Phone: 513-948-2308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number520026
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number520026
License Number StateOH

VIII. Authorized Official

Name: LORI J WARD
Title or Position: EXECUTIVE DIRECTOR
Credential: LNHA
Phone: 513-948-2308