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Organization

THE WELLSPRING FOUNDATION, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. HARVEY NEWMAN M.ED (CHIEF EXECUTIVE OFFICER)
(203) 266-8110
Entity
Organization

Contact information

Practice address
21 ARCH BRIDGE RD., BETHLEHEM, CT 06751-0370
(203) 266-8000
(203) 266-8030
Mailing address
21 ARCH BRIDGE RD., P.O. BOX 370, BETHLEHEM, CT 06751-0370
(203) 266-8000
(203) 266-8030

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
323P00000X
Psychiatric Residential Treatment Facility
Primary
CCF RT 26
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004040929
CT
Enumeration date
01/23/2007
Last updated
11/13/2008
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