Provider Demographics
NPI:1942483938
Name:MONET HOME
Entity Type:Organization
Organization Name:MONET HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLMAYNE
Authorized Official - Middle Name:SEABERRY
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-798-8638
Mailing Address - Street 1:PO BOX 41452
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27629-1452
Mailing Address - Country:US
Mailing Address - Phone:919-798-8638
Mailing Address - Fax:919-874-0531
Practice Address - Street 1:6701 LITCHFORD RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-7112
Practice Address - Country:US
Practice Address - Phone:919-798-8638
Practice Address - Fax:919-874-0531
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAKE BEHAVIORAL & HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL092631320600000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No347C00000XTransportation ServicesPrivate Vehicle