Organization
MONARCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CINDY JONES (CFO)
(704) 986-1522
Entity
Organization
Contact information
Practice address
1615 MOSS SPRINGS RD, ALBEMARLE, NC 28001-7820
(704) 982-5619
(704) 982-3850
Mailing address
350 PEE DEE AVE, SUITE A, ALBEMARLE, NC 28001-4945
(704) 986-1522
(704) 982-5279
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
311Z00000X
Custodial Care Facility
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
MHL-084-065
NC
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3406481
—
NC
Enumeration date
02/09/2007
Last updated
03/31/2021
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