NPIMap

Organization Active NPI

Springwell Network, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Winston Salem, NC
National Provider Identifier
1427137017
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-034-365 Issued in NC
Legal business name
SPRINGWELL NETWORK, INC.
Practice address
3820 North Patterson Avenue
Winston Salem, NC 27105-3140
Phone
(336) 831-1300
Fax
(336) 831-1314
NPI assigned
Nov 3, 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
Case Management Agency 251B00000X MHL-034151 NC
Community/Behavioral Health Agency 251S00000X MHL-034-365 NC
Adult Care Home Facility 311ZA0620X MHL-034-365 NC
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-034-365 NC Primary

Addresses

Primary practice location

3820 North Patterson Avenue
Winston Salem, NC 27105-3140

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
3418209MedicaidNC

Other names 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2175126Springwell Network, Inc3820 N Patterson Avenue, Winston-Salem, NC 27105Certificate of waiverNov 14, 2027

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": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518998400000",
    "number": "1427137017",
    "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": "3820 NORTH PATTERSON AVENUE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271053140",
            "telephone_number": "336-831-1300",
            "fax_number": "336-831-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGWELL NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "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": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "MHL-034151",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-034-365",
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "MHL-034-365",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-034-365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3418209",
            "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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.