WELLSPRING CENTRALIA LLC
NPI 1063257145
Alzheimer Center (Dementia Center) in Centralia, WA

Q: What is Wellspring Centralia LLC's NPI number?

The NPI number for Wellspring Centralia LLC is 1063257145. It was assigned to this organization in the NPPES registry on June 28, 2024.

Q: What is Wellspring Centralia LLC's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Active since June 28, 2024CLIA 50D2335564 · Waiver

1215 S TOWER AVE, CENTRALIA, WA 98531(425) 900-1108(360) 807-4326 Get Directions Write a Review

NPPES record last updated: June 28, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Wellspring Centralia Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLSPRING CENTRALIA LLC (NPI 1063257145) is a healthcare organization registered as an alzheimer center (dementia center) in Centralia, Washington and active in the NPI registry since June 2024. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Tina Wong, Cfo, as its authorized official.

NPPES Registry Identity

NPI1063257145

Entity TypeOrganization

Primary Taxonomy311500000X

Legal Business NameWELLSPRING CENTRALIA LLC

Location Address1215 S TOWER AVECentralia, WA 98531-2338

Mailing Address1215 S Tower AveCentralia, WA 98531-2338 · (425) 900-1108 · Fax (360) 807-4326

Phone(425) 900-1108

Fax(360) 807-4326

Organization SubpartNo

Authorized OfficialTina WongCfo · (425) 900-1108

Enumeration DateJune 28, 2024

NPPES CertifiedJune 28, 2024

✔ NPI 1063257145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAlzheimer Center (Dementia Center)Nursing & Custodial Care Facilities

Taxonomy Code311500000X

Definition

A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.

1215 S TOWER AVE, Centralia, WA 98531

Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2335564

Wellspring Centralia · Centralia, WA

Active · expires Apr 4, 2028

CLIA Number50D2335564

Laboratory TypeAssisted Living Facility

Certificate Effective DateDecember 12, 2025

Certificate Expiration DateApril 4, 2028

Laboratory DirectorDenage Cagle

Laboratory Phone(360) 389-3199

Laboratory LocationWellspring Centralia1215 S Tower Ave, Centralia, WA 98531

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDRA CARE

Assisted Living Facility

1215 S TOWER AVE
CENTRALIA, WA 98531

Lewis County (360) 807-4237

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wellspring Centralia LLC's NPI number?

The NPI number for Wellspring Centralia LLC is 1063257145. It was assigned to this organization in the NPPES registry on June 28, 2024.

Where is Wellspring Centralia LLC located?

Wellspring Centralia LLC is located at 1215 S Tower Ave, Centralia, WA 98531. The listed phone number is (425) 900-1108.

What is Wellspring Centralia LLC's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Does Wellspring Centralia LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2335564) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wellspring Centralia LLC was last updated on June 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.