Organization
MONARCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI MANESS (CONTROLLER)
(704) 986-1523
Entity
Organization
Contact information
Practice address
1810 BACK CREEK DRIVE, CHARLOTTE, NC 28213
(704) 986-1500
Mailing address
350 PEE DEE AVE STE 101, ALBEMARLE, NC 28001-4945
(704) 986-1522
(704) 982-7952
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408752
—
NC
Enumeration date
07/21/2017
Last updated
05/27/2026
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