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Organization
BLUEMOON HEALTH MANAGEMENT
Active
Organization
BLUEMOON HEALTH MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN KNIGHT (DIRECTOR/OWNER)
(585) 709-3388
Entity
Organization
Contact information
Practice address
196 BUFFALO AVE, SUITE 3B, BROOKLYN, NY 11213-3283
(585) 709-3388
Mailing address
196 BUFFALO AVE, APT 3B, BROOKLYN, NY 11213-3282
(585) 709-3388
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
NULL
Other
Enumeration date
12/28/2016
Last updated
12/28/2016
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