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General NPI Number Information
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NPI Number | 1427941095
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Entity Type | Organization
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Legal Business Name | THE WELLSPRING HEALTH MINISTRY
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 143 BALTIMORE AVE
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City | HILLSIDE
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State | NJ
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Zip | 07205-2638
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Country | US
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Telephone | 908-477-3033
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Fax |
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Provider Business Mailing Address
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Address Line | 143 BALTIMORE AVE
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City | HILLSIDE
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State | NJ
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Zip | 07205-2638
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Country | US
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Telephone | 908-477-3033
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Fax |
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Authorized Official
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Title or Position | FOUNDER & CEO
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Name | MS. JENICE CALDWELL
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Credential | FNP-C
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Telephone | 908-477-3033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LC1500X
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Taxonomy Name | Community Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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