MEDICARE: MONARCH

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	251S00000X	Community/Behavioral Health Agency
2	315P00000X	Intellectual Disabilities Intermediate Care Facility
3	311Z00000X	Custodial Care Facility
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
5	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	MHL-025-002	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710028279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONARCH

Provider Business Mailing Address
First Line	:	350 PEE DEE AVE
Second Line	:	SUITE A
City	:	ALBEMARLE
State	:	NC
Zip	:	28001-4945
Country	:	US
Telephone Number	:	704-986-1522
Fax Number	:	704-982-5279

Provider Business Practice Location Address
First Line	:	3000 BRICES CREEK RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-8592
Country	:	US
Telephone Number	:	252-635-5377
Fax Number	:	252-635-9809

Authorized Official
Title or Position	:	CFO
Name	:	MRS. CINDY JONES
Credential	:
Telephone Number	:	704-986-1522

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	12/20/2020

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Directions to “MONARCH ” Practice Location

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