NPIMap

Organization Active NPI

Wellspring Community Support Services, Inc.

  • Adult Mental Health Clinic/Center
  • Mansfield, PA
National Provider Identifier
1144451121
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
221170 Issued in PA
Legal business name
WELLSPRING COMMUNITY SUPPORT SERVICES, INC.
Practice address
3Rd & St. James Street
St. James Complex #206B
Mansfield, PA 16933
Phone
(570) 662-2821
Fax
(570) 662-2822
NPI assigned
Aug 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Authorized official

Name
Frank M. Von Hendy, LSW
Title
President
Phone
(570) 662-1064

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 221170 PA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 221170 PA
Adult Mental Health Clinic/Center 261QM0850X 221170 PA Primary
Adult Mental Health Clinic/Center 261QM0850X 222350 PA
Rehabilitation Clinic/Center 261QR0400X 221170 PA

Addresses

Primary practice location

3Rd & St. James Street
St. James Complex #206B
Mansfield, PA 16933

Mailing address

PO Box 574
Mansfield, PA 16933-0574
Phone (570) 662-1064

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1144451121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 574",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169330574",
            "telephone_number": "570-662-1064",
            "fax_number": "570-662-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3RD & ST. JAMES STREET",
            "address_2": "ST. JAMES COMPLEX #206B",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "16933",
            "telephone_number": "570-662-2821",
            "fax_number": "570-662-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING COMMUNITY SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-07",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "VON HENDY",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-662-1064",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "221170",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "221170",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "221170",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "222350",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "PA",
            "license": "221170",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.