Organization
MONARCH MENTAL HEALTH ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA EWING PA-C (FOUNDER/CEO)
(480) 737-1240
Entity
Organization
Contact information
Practice address
5393 ROOSEVELT BLVD STE 8, JACKSONVILLE, FL 32210-8424
(480) 737-1240
Mailing address
5393 ROOSEVELT BLVD STE 8, JACKSONVILLE, FL 32210-8424
(480) 737-1240
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437404639
—
TX
Enumeration date
08/14/2020
Last updated
09/04/2020
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