Living Waters Ventures, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

R2585 Issued in MD

Legal business name

LIVING WATERS VENTURES, INC

Practice address

1008 Leslie Ave
Catonsville, MD 21228-2912

Phone

(410) 878-6741

NPI assigned

Sep 5, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ade Olusoji Bankole

Title

Administrator

Phone

(410) 878-6741

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Living Waters Residential Services Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1700034428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 LESLIE AVE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212282912",
            "telephone_number": "410-878-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 LESLIE AVE",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212282912",
            "telephone_number": "410-878-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS VENTURES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "BANKOLE",
        "authorized_official_first_name": "ADE",
        "authorized_official_middle_name": "OLUSOJI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-878-6741"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "R2585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7405049-00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Waters Residential Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ling Lin
• Barbara Lingenfelter, LCPC
• Martin Reid Linker, M.D.
• Lionheart Therapy LLC
• Marc Neil Lipton, D.P.M.
• Rachel Lohrmann
• Jack Martin Long, PH.D.
• Joanna Marie Klosek Longo
• Juan Miranda Lopez, MD
• Louisa M Lopez, M.A., CCC-SLP, TSSLD

• Home Health Agency in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Home Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.