Cathedral Of Living Waters Incg | |
254 Clinton Ave Apt 2 Jersey City NJ 07304-1608 | |
(917) 830-5239 | |
Not Available |
Full Name | Cathedral Of Living Waters Incg |
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Speciality | Social Worker |
Location | 254 Clinton Ave Apt 2, Jersey City, New Jersey |
Authorized Official Name and Position | Alisha Maria Thompson (OWNER/CEO) |
Authorized Official Contact | 9178305239 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Cathedral Of Living Waters Incg 254 Clinton Ave Apt 2 Jersey City NJ 07304-1608 Ph: (917) 830-5239 | Cathedral Of Living Waters Incg 254 Clinton Ave Apt 2 Jersey City NJ 07304-1608 Ph: (917) 830-5239 |
NPI Number | 1396553269 |
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Provider Enumeration Date | 12/24/2024 |
Last Update Date | 12/30/2024 |
Certification Date | 12/30/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396553269 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
104100000X | Social Worker | (* (Not Available)) | Primary |
164W00000X | Licensed Practical Nurse | (* (Not Available)) | Secondary |
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