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General NPI Number Information
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NPI Number | 1700118999
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Entity Type | Organization
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Legal Business Name | MONARCH MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 02/12/2010
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Last Update Date | 05/17/2016
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Provider Practice Location Address
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Address Line | 2115 E. SHERMAN AVE #104
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City | COEUR D 'ALENE
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State | ID
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Zip | 83814
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Country | US
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Telephone | 208-676-1075
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Fax | 208-676-1245
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Provider Business Mailing Address
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Address Line | 2115 E. SHERMAN AVE #104
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City | COEUR D 'ALENE
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State | ID
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Zip | 83814
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Country | US
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Telephone | 208-676-1075
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Fax | 208-676-1245
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Authorized Official
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Title or Position | CEO
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Name | MRS. LINDA MADREE 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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | LCSW-29101
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LCSW-29101
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | LCSW-29101
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LCSW-29101
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License Number State | ID
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