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Living Water Prevention Program Facility
Mental Health Clinic/Center (Including Community Mental Health Center) in Sparta, Tennessee
NPI 1184852048

Living Water Prevention Program Facility is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Sparta, TN and is specialized in Mental Health (Including Community Mental Health Center). Living Water Prevention Program Facility practices in Sparta, TN. The NPI Number for Living Water Prevention Program Facility is 1184852048 and holds a License No. I000000004501 (Tennessee).

The current practice location address for Living Water Prevention Program Facility is 959 Old Cookeville Rd, Sparta, TN and can be reached out via phone at 931-738-8102.

Location: 959 Old Cookeville Rd, Sparta, TN, 38583-5616
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1184852048
Provider Name
Living Water Prevention Program Facility
Credential
Provider Entity Type
Organization
Address
959 Old Cookeville Rd, Sparta, TN, 38583-5616
Phone Number
931-738-8102
Fax Number
Provider Enumeration Date
06/30/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
959 Old Cookeville Rd
City
Sparta
State
Tennessee
Zip
38583-5616
Phone Number
931-738-8102
Fax Number
person
Provider Business Mailing Address Details
Address
959 Old Cookeville Rd
City
Sparta
State
Tennessee
Zip
38583-5616
Phone Number
931-738-8102
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
I000000004501 (Tennessee)
Definition
Definition to come...
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