MEDICARE: MONARCH GROUP HOME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1134820194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONARCH GROUP HOME LLC

Provider Business Mailing Address
First Line	:	6112 FISHER AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-5625
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6112 FISHER AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-5625
Country	:	US
Telephone Number	:	702-750-8938
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	SEAN STERN
Credential	:
Telephone Number	:	702-572-9798

Provider Enumeration Date	:	03/15/2023
Last Update Date	:	03/15/2023

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Directions to “MONARCH GROUP HOME LLC ” Practice Location

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