Basic Information
Provider Information
NPI: 1073800421
EntityType: 2
ReplacementNPI:  
OrganizationName: MONARCH
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 350 PEE DEE AVE
Address2: SUITE A
City: ALBEMARLE
State: NC
PostalCode: 280014945
CountryCode: US
TelephoneNumber: 7049861500
FaxNumber: 7049825279
Practice Location
Address1: 400 DOGWOOD CIR
Address2:  
City: HIGH POINT
State: NC
PostalCode: 272602514
CountryCode: US
TelephoneNumber: 3368848278
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/06/2011
LastUpdateDate: 03/31/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: JONES
AuthorizedOfficialFirstName: CINDY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 7049861522
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
310400000X  N Nursing & Custodial Care FacilitiesAssisted Living Facility 
251S00000X  N AgenciesCommunity/Behavioral Health 
311ZA0620X  Y Nursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home

No ID Information.


Home