| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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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