NPI | 1164006573 |
---|---|
Doing Business As | JACOBS WELL CHURCH COUNSELING |
Entity Type | Organization |
Authorized Contact | SPENCER REA HANSEN THOMAS Pastor Of Care And Counseling 309-532-2364 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2021-05-11 |
Last Update Date | 2021-05-11 |