NPIMap

Organization Active NPI

Springwell Network, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Winston Salem, NC
National Provider Identifier
1215028246
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-034-361 Issued in NC
Legal business name
SPRINGWELL NETWORK, INC.
Practice address
3830 Ebert Street
Winston Salem, NC 27127-5742
Phone
(336) 785-2635
Fax
(336) 831-1314
NPI assigned
Sep 27, 2006
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-034-361 NC
Adult Care Home Facility 311ZA0620X MHL-034-361 NC
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL034150 NC
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-034-361 NC Primary

Addresses

Primary practice location

3830 Ebert Street
Winston Salem, NC 27127-5742

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
7804420MedicaidNC

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.

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": "1215028246",
    "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": "3830 EBERT STREET",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271275742",
            "telephone_number": "336-785-2635",
            "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-034-361",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-034-361",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL034150",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-034-361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804420",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Group Homes of Forsyth, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Winston Salem, 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.