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WELLSPRING
NPI 1275526303
Substance Abuse Rehabilitation Facility in Bangor, ME

Active since August 24, 2005CLIA 20D2269650 · Waiver
255 HAMMOND ST., BANGOR, ME 04401(207) 941-1612(207) 941-1634 Get Directions Write a Review

NPPES record last updated: August 17, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Wellspring NPPES

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

WELLSPRING (NPI 1275526303) is a healthcare organization registered as a substance abuse rehabilitation facility in Bangor, Maine and active in the NPI registry since August 2005. The organization holds a CLIA Waiver certificate valid through September 29, 2026 and lists Patricia A. Kimball, Executive Director Registered Agent, as its authorized official.

NPPES Registry Identity

NPI1275526303
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameWELLSPRING, INC.
Location Address255 HAMMOND ST.Bangor, ME 04401-5294
Mailing Address98 Cumberland StBangor, ME 04401-5234 · (207) 941-1612 · Fax (207) 941-1634
Phone(207) 941-1612
Fax(207) 941-1634
Organization SubpartNo
Authorized OfficialPatricia A. KimballExecutive Director Registered Agent · (207) 941-1612
Enumeration DateAugust 24, 2005
Last NPPES UpdateAugust 17, 2018
✔ NPI 1275526303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in ME · 290961
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X · License 291041 (ME)
255 HAMMOND ST., Bangor, ME 04401
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Other Names 1

Doing Business AsWellspring

Other Identifiers 5

Medicaid164940100ME
Medicaid164940001ME
Medicaid164940003ME
Medicaid164940000ME
Medicaid164940002ME

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 20D2269650

Wellspring, Inc · Bangor, ME
Active · expires Sep 29, 2026
CLIA Number20D2269650
Laboratory TypeSud Residential Pnmi
Certificate Effective DateSeptember 30, 2024
Certificate Expiration DateSeptember 29, 2026
Laboratory DirectorRaymond Baxter
Laboratory Phone(207) 941-1639
Laboratory LocationWellspring, Inc319 State Street, Bangor, ME 04401
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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, Inc.'s NPI number?

The NPI number for Wellspring, Inc. is 1275526303. It was assigned to this organization in the NPPES registry on August 24, 2005. The provider is doing business as Wellspring.

Where is Wellspring, Inc. located?

Wellspring, Inc. is located at 255 Hammond St., Bangor, ME 04401. The listed phone number is (207) 941-1612.

What is Wellspring, Inc.'s specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Wellspring, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D2269650) is associated with this NPI, valid through September 29, 2026. 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, Inc. was last updated on August 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.