Provider Demographics
NPI:1669825436
Name:MONARCH IN ALBEMARLE
Entity Type:Organization
Organization Name:MONARCH IN ALBEMARLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACTT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBINO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:704-912-8741
Mailing Address - Street 1:1252 UNION RD
Mailing Address - Street 2:D
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0505
Mailing Address - Country:US
Mailing Address - Phone:704-912-8741
Mailing Address - Fax:
Practice Address - Street 1:1252 UNION RD
Practice Address - Street 2:D
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0505
Practice Address - Country:US
Practice Address - Phone:704-912-8741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC009764251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health