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Organization
MOONLITE HOMEHEALTHCARE
Active
Organization
MOONLITE HOMEHEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERAJ ADEM (OWNER)
(614) 596-7581
Entity
Organization
Contact information
Practice address
1314 BRICE RD, REYNOLDSBURG, OH 43068-2311
(614) 751-8865
Mailing address
1314 BRICE RD, REYNOLDSBURG, OH 43068-2311
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376093807
NPI
—
05
—
1376093807
—
OH
Enumeration date
12/06/2017
Last updated
12/06/2017
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