Provider Demographics
NPI:1760607840
Name:THERAPY NETWORK, INC
Entity Type:Organization
Organization Name:THERAPY NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SCHRUPP
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:507-454-0000
Mailing Address - Street 1:66 SHADY OAK CT
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-6034
Mailing Address - Country:US
Mailing Address - Phone:507-454-0000
Mailing Address - Fax:507-454-6724
Practice Address - Street 1:66 SHADY OAK CT
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-6034
Practice Address - Country:US
Practice Address - Phone:507-454-0000
Practice Address - Fax:507-454-6724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN246534Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER