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General NPI Number Information
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NPI Number | 1326294554
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Entity Type | Organization
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Legal Business Name | MONARCH, INC
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 2310 W BROADWAY ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-2761
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Country | US
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Telephone | 918-682-7210
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Fax | 918-682-0801
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Provider Business Mailing Address
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Address Line | PO BOX 1267
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City | MUSKOGEE
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State | OK
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Zip | 74402-1267
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Country | US
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Telephone | 918-682-7210
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Fax | 918-682-0801
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Authorized Official
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Title or Position | SUBSTANCE ABUSE COUNSELOR
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Name | MRS. TOMMYE JOANN WILLIAMS
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Credential | BS
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Telephone | 918-682-7210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 324500000X
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License Number State | OK
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