Provider Demographics
NPI:1003231309
Name:MONROE MANOR THERAPY SERVICES INC.
Entity Type:Organization
Organization Name:MONROE MANOR THERAPY SERVICES INC.
Other - Org Name:MONROE MANOR THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-957-8460
Mailing Address - Street 1:1101 BAUCOM RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-7584
Mailing Address - Country:US
Mailing Address - Phone:704-776-9327
Mailing Address - Fax:888-704-5820
Practice Address - Street 1:1101 BAUCOM RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7584
Practice Address - Country:US
Practice Address - Phone:704-776-9327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-23
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)