Provider Demographics
NPI:1134908882
Name:NEW TESTAMENT BAPTIST CHURCH OF MONROE, INC.
Entity type:Organization
Organization Name:NEW TESTAMENT BAPTIST CHURCH OF MONROE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-283-5606
Mailing Address - Street 1:2603 GOLDMINE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-8947
Mailing Address - Country:US
Mailing Address - Phone:704-283-5606
Mailing Address - Fax:
Practice Address - Street 1:2603 GOLDMINE RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-8947
Practice Address - Country:US
Practice Address - Phone:704-283-5606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care