Healthcare Provider Details

I. General information

NPI: 1164850525
Provider Name (Legal Business Name): MONARCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2013
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 COURT DR
GASTONIA NC
28054-2140
US

IV. Provider business mailing address

350 PEE DEE AVE SUITE 101
ALBEMARLE NC
28001-4932
US

V. Phone/Fax

Practice location:
  • Phone: 704-842-6354
  • Fax: 704-982-5279
Mailing address:
  • Phone: 704-986-1500
  • Fax: 704-982-5279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CINDY B JONES
Title or Position: CFO
Credential:
Phone: 704-986-1522