| Organization Name: | JAN C BOGGS INC |
| NPI Number: | 1194744383 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAN C BOGGS (PRESIDENT) |
| Mailing Address: | 155 Diplomat Dr Suite C Columbia City |
| State: | IN US |
| Postal Code: | 467251330 |
| Phone Number: | 2602440264 |
| Fax Number: | 2602441983 |
| NPI Enumeration Date: | 07/19/2006 |
| NPI Last Update Date: | 06/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 34000520A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |