Provider Demographics
NPI:1952793648
Name:COMMUNITY THERAPIES INC
Entity Type:Organization
Organization Name:COMMUNITY THERAPIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:575-366-5014
Mailing Address - Street 1:100 E MANANA BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-3503
Mailing Address - Country:US
Mailing Address - Phone:575-366-5014
Mailing Address - Fax:575-366-5015
Practice Address - Street 1:100 E MANANA BLVD STE 1
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-3503
Practice Address - Country:US
Practice Address - Phone:575-769-2243
Practice Address - Fax:575-762-6452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation