Organization
BLUE MOON ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARRIE LOUISE SONNEBORN PHD (CEO)
(908) 432-9309
Entity
Organization
Contact information
Practice address
1250 KLINE ST, LAKEWOOD, CO 80215-4538
(908) 432-9309
Mailing address
1250 KLINE ST, LAKEWOOD, CO 80215-4538
(908) 432-9309
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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