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Organization
WELLSPRING LIFE CENTER, LLC
Active
Organization
WELLSPRING LIFE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMIKA MOORE LISW-S (CLINICAL DIRECTOR)
(216) 714-2151
Entity
Organization
Contact information
Practice address
20150 LAKE SHORE BLVD, EUCLID, OH 44123-1839
(216) 714-2151
Mailing address
20150 LAKE SHORE BLVD, EUCLID, OH 44123-1839
(216) 714-2151
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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