Provider Demographics
NPI:1992441364
Name:MONARCH RECOVERY STC LLC
Entity type:Organization
Organization Name:MONARCH RECOVERY STC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-850-2686
Mailing Address - Street 1:2759 SAILOR AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-4159
Mailing Address - Country:US
Mailing Address - Phone:805-850-2686
Mailing Address - Fax:
Practice Address - Street 1:2660 E MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2777
Practice Address - Country:US
Practice Address - Phone:805-850-2686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Single Specialty
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility