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WELLSPRINGS RESIDENCE LLC NPI 1275010969


NPI Information

NPI: 1275010969
Provider Name: WELLSPRINGS RESIDENCE LLC

Former Legal Business Name: BLACK RING CAPITAL INVESTMENTS LLC

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization
Address:
700 E WELCH RD
APOPKA, FL
ZIP 32712
Phone: (407) 880-8020
Get Directions

WELLSPRINGS RESIDENCE LLC is a nursing facility intermediate care facility in Apopka, FL. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. WELLSPRINGS RESIDENCE LLC NPI is 1275010969. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Black Ring Capital Investments Llc.

The provider's business location address is:

700 E WELCH RD
APOPKA, FL
ZIP 32712-921
Phone: (407) 880-8020
Fax: (407) 264-8660

The provider's authorized official is Susan I. Kornegay .
The authorized official title is Authorized Managing Member and has the following contact phone number (407) 951-0268.

The enumeration date for this NPI number is 7/25/2018 and was last updated on 10/6/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251B00000XCase ManagementNo
2251E00000XHome HealthNo
3251J00000XNursing CareNo
4251S00000XCommunity/Behavioral HealthNo
5253Z00000XIn Home Supportive CareNo
6261QA0600XClinic/CenterAdult Day CareNo
7261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
8261QM0850XClinic/CenterAdult Mental HealthNo
9310400000XAssisted Living FacilityNo
10311500000XAlzheimer Center (Dementia Center)No
11314000000XSkilled Nursing FacilityNo
12385H00000XRespite CareNo
13313M00000XNursing Facility/Intermediate Care FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
196EQ6OTHERSAM CAGE CODE
2100011400MEDICAIDFLORIDA
3GJHJCRUH32H5OTHERSAM UNIQUE ENTITY ID
411968599OTHERFLORIDAAGENCY FOR HEALTHCARE ADMINISTRATION (AHCA)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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