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Organization
WATER OF LIFE COMMUNITY CHURCH
Active
Organization
WATER OF LIFE COMMUNITY CHURCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIM KENSINGER (EXECUTIVE DIRECTOR OF OPERATIONS)
(909) 463-3915
Entity
Organization
Contact information
Practice address
8440 NUEVO AVE, FONTANA, CA 92335-3824
(909) 803-1059
Mailing address
14418 MILLER AVE STE K, FONTANA, CA 92336-4265
(909) 803-1059
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
Other
Enumeration date
08/08/2024
Last updated
07/31/2026
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