Basic Information
| Provider Information | |||||||||
| NPI: | 1720601602 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MONARCH BEHAVIORAL THERAPY BII, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14131 MIDWAY RD STE 800 | ||||||||
| Address2: | |||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750013627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8557827822 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10789 BRADFORD RD STE 150 | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801276405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7206427019 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2020 | ||||||||
| LastUpdateDate: | 02/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | EDWARDS | ||||||||
| AuthorizedOfficialFirstName: | CARLA | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8557827822 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MONARCH BEHAVIORAL THERAPY | ||||||||
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| NPICertificationDate: | 02/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 193200000X MULTI-SPECIALTY GROUP | 103K00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.