Provider Demographics
NPI:1295205615
Name:MONUMENTAL BEHAVIORAL HEALTH INC
Entity type:Organization
Organization Name:MONUMENTAL BEHAVIORAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOCHEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-370-1254
Mailing Address - Street 1:1201 N POST RD STE C
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4246
Mailing Address - Country:US
Mailing Address - Phone:317-405-8833
Mailing Address - Fax:317-672-2398
Practice Address - Street 1:1201 N POST RD STE C
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4246
Practice Address - Country:US
Practice Address - Phone:317-405-8333
Practice Address - Fax:317-672-2398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty