Organization
THERAPEUTIC WATERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY WATERS (OWNER)
(445) 234-0824
Entity
Organization
Contact information
Practice address
6615 N 4TH ST, PHILADELPHIA, PA 19126-3123
(445) 234-0824
Mailing address
6615 N 4TH ST, PHILADELPHIA, PA 19126-3123
(452) 340-8244
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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