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General NPI Number Information
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NPI Number | 1154689727
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Entity Type | Organization
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Legal Business Name | MONARCH MENTAL HEALTH
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Dates
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Enumeration Date | 05/02/2012
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Last Update Date | 05/02/2012
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Provider Practice Location Address
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Address Line | 1713 E SHERMAN AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83814-5326
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Country | US
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Telephone | 208-676-1075
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Fax |
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Provider Business Mailing Address
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Address Line | 1713 E SHERMAN AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83814-5326
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Country | US
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Telephone | 208-676-1075
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. LINDA LEONARD
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Credential | LCSW
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Telephone | 208-676-1075
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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 | LPC708
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License Number State | ID
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