Organization
LIVING WELL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSLINE DIBONGE LCSW-C (OWNER)
(301) 728-9095
Entity
Organization
Contact information
Practice address
5004 JUDICIAL WAY, FREDERICK, MD 21703-4807
(240) 745-5851
Mailing address
6214 PAYTON WAY, FREDERICK, MD 21703-2730
(301) 728-9095
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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