Healthcare Provider Details

I. General information

NPI: 1245926005
Provider Name (Legal Business Name): MONARCH HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 04/14/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 THOMAS JOHNSON DR STE 203
FREDERICK MD
21702-4576
US

IV. Provider business mailing address

174 THOMAS JOHNSON DR STE 203
FREDERICK MD
21702-4576
US

V. Phone/Fax

Practice location:
  • Phone: 202-412-0658
  • Fax: 202-379-7730
Mailing address:
  • Phone: 301-624-9516
  • Fax: 202-379-7730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. CATHERINE W MATHENGE
Title or Position: ADMIN
Credential:
Phone: 202-412-0658