| NPI | 1194222489 |
|---|---|
| Doing Business As | WATER OF LIFE |
| Entity Type | Organization |
| Authorized Contact | KELSEY KREIDER STARRS Owner 612-220-2757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 19329) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2021-04-05 |