Organization
LIVING WATER COMMUNITY DEVELOPMENT CORPORATION, INC
Active
Organization
LIVING WATER COMMUNITY DEVELOPMENT CORPORATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA LENOR GOODING PHD (CEO)
(704) 822-3004
Entity
Organization
Contact information
Practice address
3906 HICKORY GROVE RD, MOUNT HOLLY, NC 28120-9618
(704) 822-3004
(704) 827-6031
Mailing address
PO BOX 267, MOUNT HOLLY, NC 28120-0267
(704) 822-3004
(704) 827-6031
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8700401
—
NC
Enumeration date
12/19/2006
Last updated
08/22/2020
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