Active NPI
Wellspring Home Health Center, LLC
- Home Health Agency
- Lakewood, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- WELLSPRING HOME HEALTH CENTER, LLC
- Doing business as
- Wellspring Home Health Center
- Practice address
- 8815 S. Tacoma Way
Suite 120
Lakewood, WA 98499 - Phone
- (253) 625-7606
- Fax
- (253) 625-7079
- NPI assigned
- Feb 19, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Ernest Ibanga Sr.
- Title
- President
- Phone
- (706) 833-9917
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
8815 S. Tacoma Way
Suite 120
Lakewood, WA 98499
Mailing address
P.O. Box 33064
Tacoma, WA 98433
Phone (253) 625-7606
Other names 1
- Wellspring Home Health Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211124000903 | WA | Part A Provider - Home Health Agency | 1951791409 | Practice locations: Lakewood, WA |
Home health agency certification: CCN 507309
- Legal name
- WELLSPRING HOME HEALTH CENTER LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jun 13, 2023
- Last certification
- May 26, 2023
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Mar 5, 2019 in WA
- Enrollment address
- 8815 S Tacoma Way
Ste 120
Lakewood, WA 98499-7011
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Wellspring Home Health Center, LLC
- Ownership
- Proprietary
- Certified
- Jun 13, 2023
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 50D2274417 | Wellspring Home Health Center, LLC | Certificate of waiver | Apr 4, 2028 |
National Provider Directory
National Provider DirectoryLocations
8815 South Tacoma Way
Ste 120
Lakewood, WA 98499
Phone (253) 625-7606
Ownership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Ernest Ibanga | 5% Or Greater Direct Ownership Interest | May 3, 2019 | 50% |
| Joyce Ibanga | 5% Or Greater Direct Ownership Interest | May 3, 2019 | 50% |
| Ernest Ibanga | Operational/Managerial Control | May 3, 2019 | 5% |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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- Anchorage, AK
- NPI 1437975646
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582070400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762992000000",
"number": "1801429733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 33064",
"city": "TACOMA",
"state": "WA",
"postal_code": "98433",
"telephone_number": "253-625-7606",
"fax_number": "253-625-7079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8815 S. TACOMA WAY",
"address_2": "SUITE 120",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "98499",
"telephone_number": "253-625-7606",
"fax_number": "253-625-7079"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WELLSPRING HOME HEALTH CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-02-19",
"last_updated": "2025-11-13",
"certification_date": "2025-11-13",
"status": "A",
"authorized_official_last_name": "IBANGA",
"authorized_official_first_name": "ERNEST",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "706-833-9917",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Sr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Wellspring Home Health Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Wellspring Home Health Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Lakewood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.