Organization
MOONLIGHT HEALTHCARE SERIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUSEGUN B ABEJIDE (OWNER)
(469) 733-8622
Entity
Organization
Contact information
Practice address
3700 GRIFBRICK DR, PLANO, TX 75075-1514
(469) 733-8622
(469) 965-9401
Mailing address
3700 GRIFBRICK DR, PLANO, TX 75075-1514
(469) 733-8622
(469) 965-9401
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/07/2020
Last updated
11/07/2020
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