Wolf Larson Enterprises LLC
NPI #1487151130 in Washington, Illinois
Provider Information
- NPI Number
- 1487151130
- Entity Type
- Organization
- Organization Name
- Wolf Larson Enterprises LLC
- Primary Specialty
- Clinic/Center - Adult Mental Health
- Enumeration Date
- Apr 10, 2018
- Last Updated
- Apr 10, 2018
Practice Location
- Address
- 1932 DEER LN
- City
- Washington
- State
- Illinois
- ZIP Code
- 61571-9679
- Phone
- (309) 208-1288
Authorized Official
- Name
- JAMES GIBB, LCPC
- Title
- OWNER
- Phone
- (309) 208-1288
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health |
| Clinic/Center - Adult Mental Health — Adult Mental Health |
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