Healthcare Provider Details

I. General information

NPI: 1548782816
Provider Name (Legal Business Name): MONARCH HEALTH AND RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2017
Last Update Date: 10/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22664 STATE ROUTE 73
WEST PORTSMOUTH OH
45663-6365
US

IV. Provider business mailing address

22664 STATE ROUTE 73
WEST PORTSMOUTH OH
45663-6365
US

V. Phone/Fax

Practice location:
  • Phone: 740-858-6656
  • Fax: 740-858-5412
Mailing address:
  • Phone: 740-858-6656
  • Fax: 740-858-5412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH L DUNCAN
Title or Position: CEO
Credential: LPN, CDCA
Phone: 740-858-6656