Provider Demographics
NPI:1154018323
Name:MONARACH
Entity type:Organization
Organization Name:MONARACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:MANESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-986-1523
Mailing Address - Street 1:350 PEE DEE AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-4945
Mailing Address - Country:US
Mailing Address - Phone:866-272-7826
Mailing Address - Fax:800-227-8961
Practice Address - Street 1:193 LOWES DR STE 101&102
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-8603
Practice Address - Country:US
Practice Address - Phone:866-272-7826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health