Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Thanonsack Manivong

Individual provider Adult Companion · NPI 1104762681

Thanonsack Manivong is an Adult Companion in Grand Island, Nebraska. Licensed in New Jersey. Registered with an NPI since 2026.

Licensed in
NJ
In the registry since
2026
Specialties on file
2

Practice location Address checks out

309 W 2nd St
Grand Island, NE 68801-5933
Phone: (308) 833-5300
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Personal Care Attendant (primary) Taxonomy 3747P1801X (NJ)
Adult Companion Taxonomy 372600000X (NJ)

Record details

NPI number1104762681
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 27, 2026
Last updated in NPPESApril 27, 2026
Certification dateApril 27, 2026

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