Healthcare Provider Details

I. General information

NPI: 1528384716
Provider Name (Legal Business Name): THE MONARCH HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 04/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14203 RICK DR
SHELBY TOWNSHIP MI
48315-2935
US

IV. Provider business mailing address

4324 BRIGGS ROAD
MARATHON TOWNSHIP MI
48464
US

V. Phone/Fax

Practice location:
  • Phone: 586-206-8051
  • Fax:
Mailing address:
  • Phone: 586-206-8051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateMI

VIII. Authorized Official

Name: LISA MCFARLAND
Title or Position: PRESIDENT
Credential: RD NHA
Phone: 586-206-8051