Provider Demographics
NPI:1154938546
Name:THE MONARCH CLINIC, LLC
Entity type:Organization
Organization Name:THE MONARCH CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CHACLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CSCD, CCC-SLP
Authorized Official - Phone:508-406-9256
Mailing Address - Street 1:107 WINTER HILL RD
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:MA
Mailing Address - Zip Code:01520-1484
Mailing Address - Country:US
Mailing Address - Phone:774-437-1424
Mailing Address - Fax:
Practice Address - Street 1:1078 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEICESTER
Practice Address - State:MA
Practice Address - Zip Code:01524-1396
Practice Address - Country:US
Practice Address - Phone:508-406-9256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty