Wellspring Second Chance Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

WELLSPRING SECOND CHANCE CENTER

Practice address

2134 44TH Ave N
Minneapolis, MN 55412-1163

Phone

(612) 296-2895

NPI assigned

Apr 29, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Deseria L Galloway, LGSW

Title

Ceo

Phone

(612) 296-2895

Specialties & licenses 1

Addresses

Other names 1

• Wellspring Second Chance Center Doing business as

Locations

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1306581889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2134 44TH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121163",
            "telephone_number": "612-296-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2134 44TH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121163",
            "telephone_number": "612-296-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING SECOND CHANCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "GALLOWAY",
        "authorized_official_first_name": "DESERIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-296-2895",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LGSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellspring Second Chance Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michele Marie Wells, PT
• William Wells, RN
• Wellshare International
• Wellsong Counseling LLC
• Wellspring CT
• Evan Rustad Welo, PA-C
• Jenna Welo
• Joseph Arthur Wels, M.D.
• Ella Maria Welsh
• Jaynie Welsh, DO

• Community/Behavioral Health Agency in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.