Organization Active NPI

Wellspring Home Health Center, LLC

  • Home Health Agency
  • Lakewood, WA
National Provider Identifier
1801429733
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Mr. Ernest Ibanga Sr.NPI 1437975646
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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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, LLCCCN 507309 · All quality measures
Ownership
Proprietary
Certified
Jun 13, 2023
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
50D2274417Wellspring Home Health Center, LLC8815 S Tacoma Way Ste 120, Lakewood, WA 98499Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Ernest Ibanga Individual 5% Or Greater Direct Ownership InterestPresident May 3, 2019 50%
Joyce Ibanga Individual 5% Or Greater Direct Ownership InterestAdministrator May 3, 2019 50%
Ernest Ibanga Individual Operational/Managerial ControlAdmin Assistant 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.

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

Verify at the official NPI Registry.