<Unavail>

LBN: Wellsprings Residence Llc
<Unavail> is an health care organization with primary practice located at 700 E Welch Rd , Apopka FL 32712-2921. The organization recently has 13 registered licenses in different health care specialties including Agencies / Case Management, Agencies / Home Health, Agencies / Nursing Care, Agencies / Community/Behavioral Health, Agencies / In Home Supportive Care, Ambulatory Health Care Facilities / Adult Day Care, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center), Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility, Respite Care Facility / Respite Care. Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility is the primary health care specialty. Wellsprings Residence Llc can be contacted via phone (407) 880-8020, or through Kornegay, Susan I. via phone (407) 951-0268.

Contact Information

Primary practice address
700 E Welch Rd Apopka FL 32712-2921
Phone: (407) 880-8020
Fax: (407) 264-8660
Website:
Map and Directions
Authorized official contact:
Name: Kornegay, Susan I. JD, MBA, BSN, RN
Phone: (407) 951-0268

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X
Agencies / Home Health 251E00000X
Agencies / Nursing Care 251J00000X
Agencies / Community/Behavioral Health 251S00000X
Agencies / In Home Supportive Care 253Z00000X
Ambulatory Health Care Facilities / Adult Day Care 261QA0600X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X
Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center) 311500000X
Nursing & Custodial Care Facilities / Nursing Facility/Intermediate Care Facility 313M00000X
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X
Respite Care Facility / Respite Care 385H00000X

Profile Details

NPI number 1275010969
LBN Legal business name Wellsprings Residence Llc
DBA Doing business as <Unavail>
Authorized official Kornegay, Susan I. JD, MBA, BSN, RN
Entity Organization
Organization subpart 1 No
Enumeration date Jul 25th, 2018
Last updated Oct 6th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275010969 NPPES
Other 96EQ6 SAM CAGE CODE
MEDICAID 100011400 SAM CAGE CODE
Other GJHJCRUH32H5 SAM CAGE CODE
Other 11968599 SAM CAGE CODE

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