Organization
MONARCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY JONES (CFO)
(704) 986-1522
Entity
Organization
Contact information
Practice address
2280 OAK GROVE RD, TRENTON, NC 28585-8154
(252) 224-1041
(252) 224-4231
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
—
—
310400000X
Assisted Living Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
MHL-052-001
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
—
7805210
—
NC
Enumeration date
06/19/2009
Last updated
12/20/2020
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