| Monumental Foundations Llc | |
|
108 N Kerr Ave Ste C2 Wilmington NC 28405-3439 | |
| (910) 540-6749 | |
| Not Available |
| Full Name | Monumental Foundations Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 108 N Kerr Ave Ste C2, Wilmington, North Carolina |
| Authorized Official Name and Position | Julie Simmons (OWNER) |
| Authorized Official Contact | 9105406749 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Monumental Foundations Llc 3953b Market St Wilmington NC 28403-1403 Ph: (910) 540-6749 | Monumental Foundations Llc 108 N Kerr Ave Ste C2 Wilmington NC 28405-3439 Ph: (910) 540-6749 |
| NPI Number | 1386159929 |
|---|---|
| Provider Enumeration Date | 12/05/2017 |
| Last Update Date | 08/07/2023 |
| Certification Date | 08/07/2023 |
| Medicare PECOS PAC ID | 5890146989 |
|---|---|
| Medicare Enrollment ID | O20240112003700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386159929 | NPI | - | NPPES |
| 1386159929 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Julie Simmons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619414349 PECOS PAC ID: 9638535065 Enrollment ID: I20240112003992 |
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