Basic Information
| Provider Information | |||||||||
| NPI: | 1669411989 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THRO COMPANY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1236 | ||||||||
| Address2: | |||||||||
| City: | MANKATO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560021236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5076258741 | ||||||||
| FaxNumber: | 5073874838 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 JAMES AVE | ||||||||
| Address2: | LAURELS PEAK REHABILITATION CENTER | ||||||||
| City: | MANKATO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560014090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5073454631 | ||||||||
| FaxNumber: | 5073444835 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 05/11/2010 | ||||||||
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| AuthorizedOfficialLastName: | THRO | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5076258741 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 328590 | MN | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 896 340 100 | 05 | MN | MEDICAID |