Healthcare Provider Details

I. General information

NPI: 1396369914
Provider Name (Legal Business Name): MONARCH BEHAVIORAL THERAPY BII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12303 E 104TH PL
COMMERCE CITY CO
80022-2097
US

IV. Provider business mailing address

15851 DALLAS PKWY STE 1150
ADDISON TX
75001-3325
US

V. Phone/Fax

Practice location:
  • Phone: 855-782-7822
  • Fax: 972-850-0882
Mailing address:
  • Phone: 855-782-7822
  • Fax: 972-850-0882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: CARLA EDWARDS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 855-782-7822