Provider Demographics
NPI:1598309718
Name:WELLSPRINGS HEALTH CARE PARTNERS, INC.
Entity Type:Organization
Organization Name:WELLSPRINGS HEALTH CARE PARTNERS, INC.
Other - Org Name:WELLSPRINGS HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:386-454-7746
Mailing Address - Street 1:PO BOX 3614
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-3614
Mailing Address - Country:US
Mailing Address - Phone:386-454-7746
Mailing Address - Fax:
Practice Address - Street 1:19204 NW US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-8783
Practice Address - Country:US
Practice Address - Phone:386-454-7746
Practice Address - Fax:386-454-3034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107400100Medicaid