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Organization
MOON RIVER, LLC
Active
Organization
MOON RIVER, LLC
Active
Parent organization
MOON RIVER, LLC
Other names
Therapy Services BCW
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOON RIVER, LLC
Authorized official
MS. MARIA T SMITH PT (PRESIDENT)
(770) 977-6866
Entity
Organization
Contact information
Practice address
790 OAK TRAIL DR., MARIETTA, GA 30062-7502
(770) 977-6866
(770) 977-6887
Mailing address
790 OAK TRAIL DR., MARIETTA, GA 30062-7502
(770) 977-6866
(770) 977-6887
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
10/13/2011
Last updated
10/13/2011
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