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NPI 1124255971

NPI 1124255971 : MONARCH : BETHEL, NC

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General NPI Number Information
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    NPI Number           |    1124255971
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    Entity Type          |    Organization 
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    Legal Business Name  |    MONARCH 
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Dates
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    Enumeration Date     |    06/19/2009
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    Last Update Date     |    06/11/2013
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Provider Practice Location Address
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    Address Line         |    199 WEST WASHINGTON STREET 
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    City                 |    BETHEL
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    State                |    NC
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    Zip                  |    27812-9497
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    Country              |    US
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    Telephone            |    252-825-0480
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    Fax                  |    252-825-1955
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Provider Business Mailing Address
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    Address Line         |    350 PEE DEE AVE SUITE A
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    City                 |    ALBEMARLE
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    State                |    NC
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    Zip                  |    28001-4945
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    Country              |    US
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    Telephone            |    704-986-1522
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    Fax                  |    704-982-5279
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Authorized Official
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    Title or Position    |    CFO
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    Name                 |     CINDY  JONES 
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    Credential           |    
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    Telephone            |    704-986-1522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    320600000X
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    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Residential Treatment Facility
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    320900000X
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    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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    License Number       |    
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    License Number State |    
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Taxonomy #4
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    Taxonomy Code        |    311ZA0620X
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    Taxonomy Name        |    Adult Care Home Facility
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    License Number       |    MHL-074-020
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    License Number State |    NC
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Taxonomy #5
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    Taxonomy Code        |    3104A0625X
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    Taxonomy Name        |    Assisted Living Facility (Mental Illness)
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    License Number       |    
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    License Number State |    
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