Healthcare Provider Details

I. General information

NPI: 1255749917
Provider Name (Legal Business Name): MONARCH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 07/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2310 W BROADWAY ST
MUSKOGEE OK
74401-2761
US

IV. Provider business mailing address

PO BOX 1267
MUSKOGEE OK
74402-1267
US

V. Phone/Fax

Practice location:
  • Phone: 918-682-7210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: RACHEL NEIGHBORS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 918-682-7210