NPI 1194152983

Living Water Christian Counseling Center

Organisation Early Intervention Provider Agency Mount Clemens, MI

Practice location

Address: 258 Nb Gratiot Ave, Mount Clemens, MI 48043-5749
Phone: (586) 954-0475

Authorised official

Name: John Elbert O'Neal
Title: Exec.Director/Owner
Phone: (586) 954-0475

Registered specialties

Early Intervention Provider Agency Primary

Agencies Taxonomy 252Y00000X

Other Early Intervention Provider Agency providers in Michigan →

Registry record

NPI: 1194152983
Entity type: Organization
NPI issued: 11 Oct 2013
Record last updated: 11 Oct 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.