Monica Marsh

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Liberty, NC

NPI 1770947137 · NPPES record last updated Apr 11, 2016

Key facts

NPI
1770947137
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
License
MHL-076-125 (NC)
Practice address
615 E Swannanoa Ave
Liberty, NC 27298-3002
Phone
(336) 622-0252
Fax
(336) 622-0252
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MHL-076-125NCMDIntellectual and/or Developmental Disabilities Residential Treatment Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Marsh'S Residential Living, LLC Residential Treatment Facility, Intellectual and/Or Developmental Disabilities Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-076-125 NC Yes

Addresses

Primary practice location

615 E Swannanoa Ave
Liberty, NC 27298-3002

Mailing address

615 E Swannanoa Ave
Liberty, NC 27298-3002
Phone (336) 633-0252

Other providers in Liberty, NC

All providers in Liberty, NC · Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.