Healthcare Provider Details

I. General information

NPI: 1104633593
Provider Name (Legal Business Name): MONROE ASSOCIATION FOR RETARDED CITIZENS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2024
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 SEMINARY ST
KEY WEST FL
33040-3481
US

IV. Provider business mailing address

PO BOX 428
KEY WEST FL
33041-0428
US

V. Phone/Fax

Practice location:
  • Phone: 305-294-9526
  • Fax:
Mailing address:
  • Phone: 305-294-9526
  • Fax: 305-292-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: CLINTON BOWER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 305-294-9526