Basic Information
| Provider Information | |||||||||
| NPI: | 1003116732 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MONARCH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 PEE DEE AVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | ALBEMARLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280014945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7049861522 | ||||||||
| FaxNumber: | 7049825279 | ||||||||
| Practice Location | |||||||||
| Address1: | 1211 ROBINHOOD CIR | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282274036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7045638894 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2010 | ||||||||
| LastUpdateDate: | 12/20/2020 | ||||||||
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| AuthorizedOfficialLastName: | JONES | ||||||||
| AuthorizedOfficialFirstName: | CINDY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 7049861522 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 12/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | N | Nursing & Custodial Care Facilities | Assisted Living Facility | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.