Organization
MOONLIGHT HOME HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASAD SALAH ABDALLE (ADMINISTRATOR)
(651) 347-3096
Entity
Organization
Contact information
Practice address
2800 SELKIRK DR APT 310C, BURNSVILLE, MN 55337-5676
(651) 347-3096
Mailing address
2800 SELKIRK DR APT 310C, BURNSVILLE, MN 55337-5676
(651) 347-3096
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
—
—
163WC0400X
Case Management Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
—
—
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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