Healthcare Provider Details
I. General information
NPI: 1659913960
Provider Name (Legal Business Name): MONARCH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/09/2019
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
470 MANCHESTER AVE
YOUNGSTOWN OH
44509-1709
US
IV. Provider business mailing address
470 MANCHESTER AVE
YOUNGSTOWN OH
44509-1709
US
V. Phone/Fax
- Phone: 330-979-1681
- Fax:
- Phone: 330-979-1681
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 177F00000X |
| Taxonomy | Lodging Provider |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251K00000X |
| Taxonomy | Public Health or Welfare Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253J00000X |
| Taxonomy | Foster Care Agency |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 347E00000X |
| Taxonomy | Transportation Broker |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385HR2060X |
| Taxonomy | Child Intellectual and/or Developmental Disabilities Respite Care |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ROBERTA
L
ROGERS
Title or Position: OWNER
Credential:
Phone: 330-979-1681