Provider Demographics
NPI:1447871678
Name:MONARCH MENTAL HEALTH LLC
Entity type:Organization
Organization Name:MONARCH MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:V
Authorized Official - Last Name:TAUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:401-217-9333
Mailing Address - Street 1:320 CENTRAL AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-2241
Mailing Address - Country:US
Mailing Address - Phone:401-217-9333
Mailing Address - Fax:541-543-2470
Practice Address - Street 1:320 CENTRAL AVE STE 212
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-2241
Practice Address - Country:US
Practice Address - Phone:401-217-9333
Practice Address - Fax:541-543-2470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1023649605OtherNPI 1
OR500777651Medicaid