Basic Information
Provider Information
NPI: 1518305861
EntityType: 2
ReplacementNPI:  
OrganizationName: MONARCH
LastName:  
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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: 169 WAYFARER CT
Address2:  
City: ROCKY MOUNT
State: NC
PostalCode: 278016212
CountryCode: US
TelephoneNumber: 7049861500
FaxNumber: 7049825279
Other Information
ProviderEnumerationDate: 06/10/2013
LastUpdateDate: 12/20/2020
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: JONES
AuthorizedOfficialFirstName: CINDY
AuthorizedOfficialMiddleName: B
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 7049861522
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 12/20/2020

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

No ID Information.


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