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General NPI Number Information
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NPI Number | 1528259975
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Entity Type | Organization
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Legal Business Name | WELLSPRING HEALTHCARE SERVICES, INC.
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 06/19/2024
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Provider Practice Location Address
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Address Line | 3590 HOBSON RD STE 404
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City | WOODRIDGE
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State | IL
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Zip | 60517-1492
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Country | US
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Telephone | 630-968-7777
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Fax | 630-968-7770
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Provider Business Mailing Address
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Address Line | 3590 HOBSON RD STE 404
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City | WOODRIDGE
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State | IL
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Zip | 60517-1492
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Country | US
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Telephone | 630-968-7777
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Fax | 630-968-7770
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RICHARD D SHROYER
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Credential | MBA
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Telephone | 630-968-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 3000103
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1010879
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License Number State | IL
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