Provider Demographics
NPI:1891417796
Name:MONUMENT HEALTH NETWORK, INC
Entity Type:Organization
Organization Name:MONUMENT HEALTH NETWORK, INC
Other - Org Name:COMMUNITY HEALTH WORKERS PROGRAM, NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT MONUMENT HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WORSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-644-4091
Mailing Address - Street 1:PO BOX 860013
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486-0013
Mailing Address - Country:US
Mailing Address - Phone:605-717-8595
Mailing Address - Fax:605-717-8618
Practice Address - Street 1:1420 N 10TH ST
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1532
Practice Address - Country:US
Practice Address - Phone:605-717-8595
Practice Address - Fax:605-717-8618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty