Provider Demographics
NPI:1528384716
Name:THE MONARCH HOME
Entity type:Organization
Organization Name:THE MONARCH HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RD NHA
Authorized Official - Phone:586-206-8051
Mailing Address - Street 1:4324 BRIGGS ROAD
Mailing Address - Street 2:
Mailing Address - City:MARATHON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48464
Mailing Address - Country:US
Mailing Address - Phone:586-206-8051
Mailing Address - Fax:
Practice Address - Street 1:14203 RICK DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-2935
Practice Address - Country:US
Practice Address - Phone:586-206-8051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI385H00000X, 253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No385H00000XRespite Care FacilityRespite Care