Organization
LIVING WATER SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE THOMAS (PRESIDENT)
(202) 460-6876
Entity
Organization
Contact information
Practice address
4300 FORBES BLVD STE 130, LANHAM, MD 20706-4375
(202) 559-9344
Mailing address
8217 KIPPIS RD, MILLERSVILLE, MD 21108-1821
(202) 460-6876
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
09/21/2019
Last updated
09/21/2019
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