Organization
LIVING WATER HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE THOMAS (CEO)
(202) 460-6876
Entity
Organization
Contact information
Practice address
2636 WADE RD SE APT 11, WASHINGTON, DC 20020-5906
(202) 460-6876
Mailing address
6300 GRENFELL CT, BOWIE, MD 20720-5331
(202) 460-6876
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
—
—
2255A2300X
Athletic Trainer
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
12/03/2016
Last updated
01/15/2018
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