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Living Water Health And Wellness LLC

Clinic/Center, Developmental Disabilities in Washington, DC. Organization (NPI-2).

NPI number1902349335
StatusActive
Last updated in NPPESJan 15, 2018

Details

NPI
1902349335
Entity type
Organization (NPI-2)
Legal business name
Living Water Health And Wellness LLC
Organization subpart
No
Enumeration date
Dec 3, 2016
Last updated
Jan 15, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QD1600X Clinic/Center, Developmental Disabilities––Yes
225500000X Specialist/Technologist––
2255A2300X Specialist/Technologist, Athletic Trainer––

Practice location

2636 Wade Rd Se Apt 11
Washington, DC 20020-5906

Phone 202-460-6876

Mailing address

6300 Grenfell Ct
Bowie, MD 20720-5331

Phone 202-460-6876

Authorized official

Stephanie Thomas
Ceo
2024606876

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