Provider Demographics
NPI:1679570394
Name:DAYSPRING, INC.
Entity type:Organization
Organization Name:DAYSPRING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-258-3673
Mailing Address - Street 1:456 AUTUMN ACRES RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-3202
Mailing Address - Country:US
Mailing Address - Phone:304-258-3673
Mailing Address - Fax:304-258-6618
Practice Address - Street 1:456 AUTUMN ACRES RD
Practice Address - Street 2:
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411-3202
Practice Address - Country:US
Practice Address - Phone:304-258-3673
Practice Address - Fax:304-258-6618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV55314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0003916000Medicaid
WV0003916001Medicaid
WV0003916001Medicaid