Provider Demographics
NPI:1881894160
Name:WELLSPRING HEALTH SERVICES
Entity type:Organization
Organization Name:WELLSPRING HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MCMILLION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-522-5201
Mailing Address - Street 1:PO BOX 608033
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32860-8033
Mailing Address - Country:US
Mailing Address - Phone:407-522-5201
Mailing Address - Fax:
Practice Address - Street 1:6239 EDGEWATER DR
Practice Address - Street 2:BLDG N2 SUITE D3
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-4736
Practice Address - Country:US
Practice Address - Phone:407-522-5201
Practice Address - Fax:407-522-5204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCERT 1921251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health