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
350 PEE DEE AVE, SUITE 101, ALBEMARLE, NC 28001-4932
(704) 986-1500
(704) 982-5279
Mailing address
350 PEE DEE AVE, SUITE 101, ALBEMARLE, NC 28001-4932
(704) 986-1522
(704) 982-5279
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408752
—
NC
Enumeration date
02/09/2007
Last updated
08/26/2025
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