WELLSPRINGS RESIDENCE LLC (NPI# 1275010969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275010969 |
| Entity Type | Organization |
| Organization Name | WELLSPRINGS RESIDENCE LLC |
| Other Organization Name | BLACK RING CAPITAL INVESTMENTS LLC |
| Practice Address |
700 E Welch Rd Apopka FL 32712-2921 |
| Practice Telephone | 4078808020 |
| Practice Fax Number | 4072648660 |
| Mailing Telephone | 4078808020 |
| Mailing Fax Number | 4072648660 |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2019-10-01 |
| Authorized Official Name | SUSAN I. KORNEGAY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4078808020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 251J00000X | Nursing Care | Agencies | ||
| N | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | AL12479 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AGENCY FOR HEALTHCARE ADMINISTRATION (AHCA) | 11968599 | 01 |
| FL | 100011400 | 05 |
| Other Name | Type Code |
|---|---|
| Black Ring Capital Investments LLC | Former Legal Business Name - Organization |
| Street Address |
700 E WELCH RD |
| City | APOPKA |
| State | FL |
| Zip Code | 32712-2921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871526392 | The Summit of Central Florida, Inc. | Religious Nonmedical Health Care Institution | 700 E Welch Rd, Apopka, FL 32712-2921 | 2006-07-08 |
| 1831620368 | Black Ring Capital Investments LLC | Assisted Living Facility | 700 E Welch Rd, Apopka, FL 32712-2921 | 2017-03-26 |
| 1922439926 | United Senior Services LLC | Custodial Care Facility | 700 E Welch Rd, Apopka, FL 32712-2921 | 2013-12-02 |
| 1215285895 | Emine O Rurut | Religious Nonmedical Nursing Personnel | 700 E Welch Rd, Apopka, FL 32712-2921 | 2012-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003428467 | Pamella Omelda Odoms-brown | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 541 Shirley Dr., Apopka, FL 32712 | 2020-08-18 |
| 1871158741 | Adventist Health System /sunbelt, Inc. | Clinic/Center | 1520 W. Orange Blossom Trail, Apopka, FL 32712 | 2019-05-07 |
| 1477088433 | Kim Johnson | Counselor | 1041 Lake Francis Drive, Apopka, FL 32712 | 2017-04-27 |
| 1497290811 | Yasmine Mollings | Behavior Technician | 1741 Parkglen Circle, Apopka, FL 32712 | 2016-12-20 |
| 1316391170 | Infinity Dental LLC | Dentist | 1450 N. Rock Springs Rd, Apopka, FL 32712 | 2016-04-19 |
| 1518368323 | Eleanor Mccall Hawthorne | Counselor | 1928 Bluff Oak St., Apopka, FL 32712 | 2014-09-11 |
| 1497092613 | Anayanzi Annette Simpson | Social Worker | 523 Wekiva Commons Circle #4, Apopka, FL 32712 | 2013-01-08 |
| 1275884553 | Marcia Annette Bryan | Nursing Home Administrator | 957 Rock Creek Street, Apopka, FL 32712 | 2012-09-26 |
| 1790067460 | Benjamin W Song | Dentist | 2053 Palm Vista Drive, Apopka, FL 32712 | 2011-09-19 |
| 1235367400 | Adventist Home Care Services | Home Health | 1109 Tall Pine Drive, Apopka, FL 32712 | 2009-06-26 |
| Find all providers in zip 32712 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372351 | Sunny Days Retirement Home | Assisted Living Facility | 2402 Greenacre Rd, Apopka, FL 32703-7704 | 2020-09-25 |
| 1902389927 | Active Care Assisted Living Facility | Assisted Living Facility | 2436 Lake Jackson Cir, Apopka, FL 32703-5846 | 2018-09-14 |
| 1700254786 | Harblin, LLC | Assisted Living Facility | 1691 Parkglen Cir, Apopka, FL 32712-8162 | 2015-09-09 |
| 1083030522 | Balmy Beach Alf of Florida Inc | Assisted Living Facility | 1030 Balmy Beach Dr, Apopka, FL 32703-5902 | 2014-03-07 |
| 1679901466 | Park Trail Placellc | Assisted Living Facility | 302 N Park Ave, Apopka, FL 32703-4150 | 2013-10-15 |
| 1962849778 | Bear Lake Retirement Home | Assisted Living Facility | 1525 Bear Lake Rd, Apopka, FL 32703-6736 | 2013-06-03 |
| 1265775076 | Arcadia Enterprises Inc | Assisted Living Facility | 5030 Cub Lake Dr, Apopka, FL 32703-1942 | 2013-03-29 |
| 1225371057 | Linda Gokool | Assisted Living Facility | 2402 Greenarce Rd, Apopka, FL 32703-7704 | 2013-03-29 |
| 1528369139 | A Dream Lake Manor Inc | Assisted Living Facility | 750 Alabama Ave, Apopka, FL 32703-5424 | 2010-11-12 |
| 1710200910 | Gilbert Nanan | Assisted Living Facility | 48 E Oak St, Apopka, FL 32703-4141 | 2010-03-02 |
| Find all providers in APOPKA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.