Organization
COOL WATERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESTER MBAYA (DIRECTOR OF OPERAATIONS AND FINANCE)
(858) 245-8327
Entity
Organization
Contact information
Practice address
4601 LOCUST LN STE 305, HARRISBURG, PA 17109-4446
(717) 545-2920
Mailing address
4601 LOCUST LN STE 305, HARRISBURG, PA 17109-4446
(717) 545-2920
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
06310501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102887053
—
PA
Enumeration date
12/02/2013
Last updated
08/19/2016
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