MEDICARE: WELLSPRINGS HOME HEALTH CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	225X00000X	Occupational Therapist
3	225XP0019X	Physical Rehabilitation Occupational Therapist
4	224Z00000X	Occupational Therapy Assistant
5	225100000X	Physical Therapist
6	225200000X	Physical Therapy Assistant
7	2355S0801X	Speech-Language Assistant
8	235Z00000X	Speech-Language Pathologist
9	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1366138018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSPRINGS HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	1340 SMITH AVE STE 200
Second Line	:
City	:	MOUNT WASHINGTON
State	:	MD
Zip	:	21209-3796
Country	:	US
Telephone Number	:	443-608-9341
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 SMITH AVE STE 200
Second Line	:
City	:	MOUNT WASHINGTON
State	:	MD
Zip	:	21209-3878
Country	:	US
Telephone Number	:	410-907-0622
Fax Number	:	667-239-1001

Authorized Official
Title or Position	:	OWNER
Name	:	MICHELLE DANIELLE DENNIS
Credential	:
Telephone Number	:	410-907-0625

Provider Enumeration Date	:	04/14/2023
Last Update Date	:	04/14/2023

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