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General NPI Number Information
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NPI Number | 1871280081
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Entity Type | Organization
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Legal Business Name | WELLSPRING CAREGIVERS, LLC
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 01/28/2024
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Provider Practice Location Address
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Address Line | 17300 RIVER RIDGE BLVD STE 201
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City | WOODBRIDGE
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State | VA
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Zip | 22191-5167
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Country | US
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Telephone | 571-466-7844
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Fax |
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Provider Business Mailing Address
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Address Line | 17300 RIVER RIDGE BLVD STE 201
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City | WOODBRIDGE
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State | VA
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Zip | 22191-5167
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Country | US
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Telephone | 571-466-7844
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LETICIA E ATTRAMS
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Credential | N/A
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Telephone | 929-351-4047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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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 | 372600000X
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Taxonomy Name | Adult Companion
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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