Organization
JAN C BOGGS INC
Active
Other names
Choices & Changes
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAN C BOGGS LCSW (PRESIDENT)
(260) 248-8059
Entity
Organization
Contact information
Practice address
155 DIPLOMAT DR, SUITE C, COLUMBIA CITY, IN 46725-1330
(260) 244-0264
(260) 244-1983
Mailing address
20 GROVE PARK DR, COLUMBIA CITY, IN 46725-1812
(260) 248-8059
(260) 244-1983
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34000520A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200532500A
—
IN
Enumeration date
07/19/2006
Last updated
06/21/2010
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