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General NPI Number Information
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NPI Number | 1881894160
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Entity Type | Organization
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Legal Business Name | WELLSPRING HEALTH SERVICES
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 6239 EDGEWATER DR BLDG N2 SUITE D3
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City | ORLANDO
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State | FL
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Zip | 32810-4736
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Country | US
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Telephone | 407-522-5201
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Fax | 407-522-5204
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Provider Business Mailing Address
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Address Line | PO BOX 608033
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City | ORLANDO
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State | FL
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Zip | 32860-8033
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Country | US
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Telephone | 407-522-5201
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MR. DENNIS WILLIAM MCMILLION
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Credential |
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Telephone | 407-522-5201
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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 | CERT 1921
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License Number State | FL
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