Healthcare Provider Details

I. General information

NPI: 1679570394
Provider Name (Legal Business Name): DAYSPRING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

456 AUTUMN ACRES RD
BERKELEY SPRINGS WV
25411-3202
US

IV. Provider business mailing address

456 AUTUMN ACRES RD
BERKELEY SPRINGS WV
25411-3202
US

V. Phone/Fax

Practice location:
  • Phone: 304-258-3673
  • Fax: 304-258-6618
Mailing address:
  • Phone: 304-258-3673
  • Fax: 304-258-6618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number55
License Number StateWV

VIII. Authorized Official

Name: MR. MICHAEL ANDERSON
Title or Position: REGIONAL MANAGER
Credential:
Phone: 304-258-3673