Organization
WELLSPRING COMMUNITY SUPPORT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK M. VON HENDY LSW (PRESIDENT)
(570) 662-1064
Entity
Organization
Contact information
Practice address
3RD & ST. JAMES STREET, ST. JAMES COMPLEX #206B, MANSFIELD, PA 16933
(570) 662-2821
(570) 662-2822
Mailing address
PO BOX 574, MANSFIELD, PA 16933-0574
(570) 662-1064
(570) 662-0966
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
221170
PA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
221170
PA
261QM0850X
Adult Mental Health Clinic/Center
Primary
221170
PA
261QM0850X
Adult Mental Health Clinic/Center
222350
PA
261QR0400X
Rehabilitation Clinic/Center
221170
PA
Other
Enumeration date
08/07/2009
Last updated
04/20/2011
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