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General NPI Number Information
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NPI Number | 1992924831
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Entity Type | Organization
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Legal Business Name | WELL SPRING RETIREMENT COMMUNITY INC.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4100 WELL SPRING DR
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City | GREENSBORO
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State | NC
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Zip | 27410-8857
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Country | US
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Telephone | 336-545-5400
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Fax | 336-545-5411
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Provider Business Mailing Address
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Address Line | 4100 WELL SPRING DR
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City | GREENSBORO
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State | NC
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Zip | 27410-8857
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Country | US
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Telephone | 336-545-5400
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Fax | 336-545-5411
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. STEPHEN PAUL FLEMING
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Credential | MBA
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Telephone | 336-545-5408
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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 | NH0546
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License Number State | NC
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