WELLSPRING, INC. (NPI# 1275526303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275526303 |
| Entity Type | Organization |
| Organization Name | WELLSPRING, INC. |
| Other Organization Name | WELLSPRING |
| Practice Address |
255 Hammond St. Bangor ME 04401-5294 |
| Mailing Address |
98 Cumberland St Bangor ME 04401-5234 |
| Practice Telephone | 2079411612 |
| Practice Fax Number | 2079411634 |
| Mailing Telephone | 2079411612 |
| Mailing Fax Number | 2079411634 |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | MS. PATRICIA A. KIMBALL (EXECUTIVE DIRECTOR REGISTERED AGENT) |
| Authorized Official Telephone | 2079411612 |
| Authorized Official Credential | L.A.D.C., C.C.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 291041 | ME | Agencies |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 290961 | ME | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 164940003 | 05 | |
| ME | 164940002 | 05 | |
| ME | 164940100 | 05 | |
| ME | 164940001 | 05 | |
| ME | 164940000 | 05 |
| Other Name | Type Code |
|---|---|
| Wellspring | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295090082 | Wellspring, Inc. | Substance Abuse Rehabilitation Facility | 1205 E Saint James St, Rapid City, SD 57701-3958 | 2012-07-09 |
| 1508254699 | Wellspring, Inc. | Substance Abuse Rehabilitation Facility | 98 Cumberland St, Bangor, ME 04401-5234 | 2014-12-26 |
| 1568694511 | Wellspring, Inc. | Community/Behavioral Health | 253-255 Hammond St., Bangor, ME 04401 | 2009-08-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | WELLSPRING, INC. | Arch Bridge Rd, Bethlehem, CT 06751 |
| Street Address |
255 HAMMOND ST. |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-5294 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760942965 | Elijah House S.l.e | Substance Abuse Rehabilitation Facility | 40 Coyote Moon Trail, Bangor, CA 95914 | 2019-03-22 |
| 1275723371 | Outpatient Chemical Dependency Agency | Substance Abuse Rehabilitation Facility | 185 Harlow St, Bangor, ME 04401-9101 | 2007-07-26 |
| 1669008876 | New Start Recovery Solutions | Substance Abuse Rehabilitation Facility | 40 Coyote Moon Trail, Bangor, CA 95914 | 2020-03-19 |
| 1508254699 | Wellspring, Inc. | Substance Abuse Rehabilitation Facility | 98 Cumberland St, Bangor, ME 04401-5234 | 2014-12-26 |
| 1205273786 | Manna Inc. | Substance Abuse Rehabilitation Facility | 629 Main St, Bangor, ME 04401-6848 | 2013-05-24 |
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| 1144432907 | Serenity House, Inc. | Substance Abuse Rehabilitation Facility | 30 Mellen St, Portland, ME 04101-2110 | 2007-05-04 |
| 1063548436 | Milestone Foundation Inc | Substance Abuse Rehabilitation Facility | 65 India St, Portland, ME 04101-4209 | 2007-02-27 |
| 1396889374 | Milestone Foundation Inc | Substance Abuse Rehabilitation Facility | 28 Portland Ave, Old Orchard Beach, ME 04064-2212 | 2007-02-16 |
| 1912538430 | The Charlie Mike Project | Substance Abuse Rehabilitation Facility | 213 W Broadway, Lincoln, ME 04457-4001 | 2020-02-03 |
| 1730673088 | Pine Tree Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 17 Bishop St, Portland, ME 04103-2659 | 2018-06-20 |
| 1568900074 | Grace Street Services, LLC | Substance Abuse Rehabilitation Facility | 88 Oxford St, Lewiston, ME 04240-7825 | 2017-02-03 |
| 1417494857 | Grace Street Services, LLC | Substance Abuse Rehabilitation Facility | 72 Auburn St, Portland, ME 04103-2104 | 2017-01-24 |
| 1215339809 | Pk Holdings, Inc. | Substance Abuse Rehabilitation Facility | 160 Preble St, Portland, ME 04101-2426 | 2014-09-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.