Healthcare Provider Details

I. General information

NPI: 1841953395
Provider Name (Legal Business Name): MONARCH RECOVERY IOP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2021
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 DONLON ST STE 15
VENTURA CA
93003-5640
US

IV. Provider business mailing address

2759 SAILOR AVE
VENTURA CA
93001-4159
US

V. Phone/Fax

Practice location:
  • Phone: 805-850-2686
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: SHAUN BELANGER
Title or Position: ADMINISTRATOR/CEO
Credential:
Phone: 805-850-2686