Intensive Out-Patient Care
NPI #1477685527 in Edwardsville, Illinois
Provider Information
- NPI Number
- 1477685527
- Entity Type
- Organization
- Organization Name
- Intensive Out-Patient Care
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Mar 12, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 156 N MAIN ST
- Address 2
- SUITE 202
- City
- Edwardsville
- State
- Illinois
- ZIP Code
- 62025-1972
- Phone
- (618) 656-7064
Authorized Official
- Name
- MS. JENNIFER MARY MANNING, LCSW
- Title
- PROGRAM DIRECTOR
- Phone
- (618) 656-7064
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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