Theophilos III (Ido) Intergenerational Diversified Outreach Ministries

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

THEOPHILOS III (IDO) INTERGENERATIONAL DIVERSIFIED OUTREACH MINISTRIES

Practice address

206 N Hayne St Ste a
Monroe, NC 28112-4866

Phone

(704) 635-8860

NPI assigned

Nov 15, 2012

Last updated

Nov 15, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Diane Cogsdell

Title

President Ceo Community Outreach

Phone

(240) 678-0143

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1053655035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N HAYNE ST STE A",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N HAYNE ST STE A",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281124866",
            "telephone_number": "704-635-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEOPHILOS III (IDO) INTERGENERATIONAL DIVERSIFIED OUTREACH MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "COGSDELL",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PRESIDENT CEO COMMUNITY OUTREACH",
        "authorized_official_telephone_number": "240-678-0143",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Monroe, NC
• Providers in Monroe, NC by specialty
• Home Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.