Organization
WELLSPRING MEADOWS, INC.
Active
Other names
Wellspring Meadows Assisted Living and In-Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
KURT R NEELY (ADMINISTRATOR/OWNER)
(208) 625-0275
Entity
Organization
Contact information
Practice address
9873 N BUTTERCUP LN, HAYDEN, ID 83835-9715
(208) 762-9001
(208) 762-9934
Mailing address
9873 N BUTTERCUP LN, HAYDEN, ID 83835-9715
(208) 762-9001
(208) 762-9934
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
310400000X
Assisted Living Facility
—
—
347C00000X
Private Vehicle
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M8072002
—
ID
05
—
M8077656
—
ID
05
—
M8077682
—
ID
Enumeration date
06/17/2020
Last updated
06/17/2020
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