Organization
LIVING WATERS PEACE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY LYNN CAIN LMHCA (OWNER/MENTAL HEALTH COUNSELOR ASSOC)
(260) 230-1180
Entity
Organization
Contact information
Practice address
3262 MALLARD COVE LN STE B, FORT WAYNE, IN 46804-2883
(260) 230-1180
Mailing address
3262 MALLARD COVE LN STE B, FORT WAYNE, IN 46804-2883
(260) 230-1180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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