Healthcare Provider Details

I. General information

NPI: 1740859289
Provider Name (Legal Business Name): MONARCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2021
Last Update Date: 06/19/2021
Certification Date: 06/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2514 11TH ST
GALENA PARK TX
77547-2006
US

IV. Provider business mailing address

2514 11TH ST
GALENA PARK TX
77547-2006
US

V. Phone/Fax

Practice location:
  • Phone: 832-410-4846
  • Fax:
Mailing address:
  • Phone: 832-410-4846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LANORAH WOODHOUSE
Title or Position: ADMINISTRATOR
Credential:
Phone: 832-410-4846