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Organization
LIVING WATER PROGRAM
Active
Organization
LIVING WATER PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLINDA C. ANDERSON MA (CLINCIAL DIRECTOR)
(301) 855-1458
Entity
Organization
Contact information
Practice address
125 THOMAS GANTT RD, HUNTINGTOWN, MD 20639-8545
(301) 855-1458
(410) 535-4505
Mailing address
125 THOMAS GANTT RD, HUNTINGTOWN, MD 20639-8545
(301) 855-1458
(410) 535-4505
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MD10104401
MD
Other
Enumeration date
05/15/2008
Last updated
01/31/2017
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