Organization
BLUE WATER HEALING CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMITA APONTE (CEO)
(810) 937-6259
Entity
Organization
Contact information
Practice address
1902 4TH ST, JACKSON, MI 49203-4040
(734) 273-9681
Mailing address
2902 LITTLE ST, PORT HURON, MI 48060-6829
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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