Provider Demographics
NPI:1659621670
Name:WELLSPRING HOME HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:WELLSPRING HOME HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CONDASE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEEKES-BEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-331-3553
Mailing Address - Street 1:10 POST OFFICE SQ FL 8
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4629
Mailing Address - Country:US
Mailing Address - Phone:877-331-3553
Mailing Address - Fax:
Practice Address - Street 1:10 POST OFFICE SQ FL 8
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4629
Practice Address - Country:US
Practice Address - Phone:877-331-3553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLSPRING MANAGEMENT GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8284251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health