Provider Demographics
NPI:1265671911
Name:M & J THERAPEUTIC SERVICES INC.
Entity Type:Organization
Organization Name:M & J THERAPEUTIC SERVICES INC.
Other - Org Name:MORGAN & JONES THERAPEUTIC SERVICES INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:I
Authorized Official - Credentials:BS, QMHP
Authorized Official - Phone:336-987-2389
Mailing Address - Street 1:1011 BRUSHY FORK DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8061
Mailing Address - Country:US
Mailing Address - Phone:336-987-2389
Mailing Address - Fax:
Practice Address - Street 1:1011 BRUSHY FORK DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27406-8061
Practice Address - Country:US
Practice Address - Phone:336-987-2389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization