Organization
MONARCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY JONES (CFO)
(704) 986-1522
Entity
Organization
Contact information
Practice address
2158 WINDEMIRE DR, KANNAPOLIS, NC 28083-6493
(704) 933-7938
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
—
—
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
MHL-013-142
NC
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7806357
—
NC
Enumeration date
03/15/2010
Last updated
06/11/2013
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