NPIMap

Organization Active NPI

Springwell Network, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Kernersville, NC
National Provider Identifier
1083705032
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL-034-366 Issued in NC
Legal business name
SPRINGWELL NETWORK, INC.
Practice address
460 Raven Ridge Rd
Kernersville, NC 27284-8046
Phone
(336) 722-3649
Fax
(336) 831-1314
NPI assigned
Sep 27, 2006
Last updated
Feb 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Charlene Warren
Title
Executive Director
Phone
(336) 831-1300

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MHL-034-366 NC
Adult Care Home Facility 311ZA0620X MHL-034-366 NC
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL034131 NC
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-034-366 NC Primary

Addresses

Primary practice location

460 Raven Ridge Rd
Kernersville, NC 27284-8046

Mailing address

3820 North Patterson Avenue
Winston Salem, NC 27105
Phone (336) 831-1300

Other identifiers 1

IdentifierTypeStateIssuer
7804419MedicaidNC

Other names 1

  • Group Homes of Forsyth, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Group Homes of Forsyth Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3820 N Patterson Ave
Winston Salem, NC 27105
Phone (336) 831-1300

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1083705032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 NORTH PATTERSON AVENUE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "27105",
            "telephone_number": "336-831-1300",
            "fax_number": "336-831-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 RAVEN RIDGE RD",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848046",
            "telephone_number": "336-722-3649",
            "fax_number": "336-831-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGWELL NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2018-02-19",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "336-831-1300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-034-366",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-034-366",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL034131",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-034-366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804419",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Group Homes of Forsyth, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.