Organization
THEOPHILOS III (IDO) INTERGENERATIONAL DIVERSIFIED OUTREACH MINISTRIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE COGSDELL (PRESIDENT CEO COMMUNITY OUTREACH)
(240) 678-0143
Entity
Organization
Contact information
Practice address
206 N HAYNE ST STE A, MONROE, NC 28112-4866
(704) 635-8860
Mailing address
206 N HAYNE ST STE A, MONROE, NC 28112-4866
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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