Organization
WELLSPRING, INC.
Active
Parent organization
WELLSPRING, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSPRING, INC.
Authorized official
MRS. PATRICIA A KIMBALL LADC, CCS (EXECUTIVE DIRECTOR REGISTERED AGENT)
(207) 941-1612
Entity
Organization
Contact information
Practice address
253-255 HAMMOND ST., BANGOR, ME 04401
(207) 941-1612
(207) 941-1634
Mailing address
98 CUMBERLAND ST, BANGOR, ME 04401-5234
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
571380
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164940100
—
ME
Enumeration date
08/10/2009
Last updated
08/10/2009
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