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General NPI Number Information
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NPI Number | 1497380505
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Entity Type | Organization
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Legal Business Name | MONARCH BEHAVIORAL HEALTH CENTER LLC
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Dates
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Enumeration Date | 03/09/2020
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 4706 COTTAGE GROVE RD STE 300
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City | MADISON
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State | WI
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Zip | 53716-1354
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Country | US
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Telephone | 608-381-3687
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Fax | 608-501-1211
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Provider Business Mailing Address
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Address Line | 2942 N 24TH ST STE 109
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City | PHOENIX
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State | AZ
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Zip | 85016-7849
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Country | US
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Telephone | 608-381-3687
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Fax | 608-501-1211
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. LORA I HUDSON
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Credential | LICENSED CLINICAL S
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Telephone | 608-381-3687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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