# MOONLITE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FirstLight Home Care Pueblo
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982094165
- **Authorized official:** WARREN MARTINSON (OWNER)
- **Authorized official phone:** (970) 209-5608

## Contact information

- **Practice address:** 2099 W US HIGHWAY 50 STE 110, PUEBLO, CO 81008-1677
- **Practice address phone:** (719) 569-7685
- **Practice address fax:** (719) 582-1659
- **Mailing address:** 2531 COLUMBINE LN, MONTROSE, CO 81401-5650
- **Mailing address phone:** (970) 209-5608
- **Mailing address fax:** (970) 249-7163

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 04V769 | CO | Yes |

## Other

- **Enumeration date:** 01/27/2015
- **Last updated:** 01/27/2015