Organization
LIVING WATER CHRISTIAN COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ELBERT O'NEAL SR. (EXEC.DIRECTOR/OWNER)
(586) 954-0475
Entity
Organization
Contact information
Practice address
258 NB GRATIOT AVE, MOUNT CLEMENS, MI 48043-5749
(586) 954-0475
Mailing address
258 NB GRATIOT AVE, MOUNT CLEMENS, MI 48043-5749
(586) 954-0475
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
10/11/2013
Last updated
10/11/2013
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