Organization
LIVING WATERS VENTURES, INC
Active
Other names
Living Waters Residential Services
Organization subpart
No
Provider details
NPI number
Authorized official
ADE OLUSOJI BANKOLE (ADMINISTRATOR)
(410) 878-6741
Entity
Organization
Contact information
Practice address
1008 LESLIE AVE, CATONSVILLE, MD 21228-2912
(410) 878-6741
Mailing address
1008 LESLIE AVE, CATONSVILLE, MD 21228-2912
(410) 878-6741
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
R2585
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7405049-00
—
MD
Enumeration date
09/05/2008
Last updated
09/05/2008
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