MEDICARE: WELLSPRING MENTORS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1518511765
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSPRING MENTORS LLC

Provider Business Mailing Address
First Line	:	22 ELMORE ST APT 1
Second Line	:
City	:	ROXBURY
State	:	MA
Zip	:	02119-3624
Country	:	US
Telephone Number	:	617-516-4761
Fax Number	:

Provider Business Practice Location Address
First Line	:	2075 CENTRE ST
Second Line	:
City	:	WEST ROXBURY
State	:	MA
Zip	:	02132-3313
Country	:	US
Telephone Number	:	617-516-4761
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE CLINICAL DIRECTOR
Name	:	MS. MELANIE ROBINSON FINDLAY
Credential	:	LICSW, CCHP-MH, CCF
Telephone Number	:	617-516-4761

Provider Enumeration Date	:	07/26/2019
Last Update Date	:	07/26/2019

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Directions to “WELLSPRING MENTORS LLC ” Practice Location

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