Healthcare Provider Details

I. General information

NPI: 1568258317
Provider Name (Legal Business Name): WEST SPRING COMMUNITY LIVING GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 NORDEEN DR
WEST MIFFLIN PA
15122-1157
US

IV. Provider business mailing address

533 NORDEEN DR
WEST MIFFLIN PA
15122-1157
US

V. Phone/Fax

Practice location:
  • Phone: 412-759-6436
  • Fax:
Mailing address:
  • Phone: 412-759-6436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN DENIS
Title or Position: CEO
Credential:
Phone: 412-759-6436