Organization
BLUE WATER CENTER FOR CHRISTIAN COUNSELING P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL CHARLES LUNDBLAD LMSW ACSW (EXECUTIVE DIRECTOR)
(810) 985-7380
Entity
Organization
Contact information
Practice address
824 HURON AVE, PORT HURON, MI 48060-3705
(810) 985-7380
(810) 985-3074
Mailing address
824 HURON AVE, PORT HURON, MI 48060-3705
(810) 985-7380
(810) 985-3074
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6801016861
MI
Other
Enumeration date
03/14/2007
Last updated
08/22/2020
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