Organization
MOONSTAR TRANSPORTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIRIYE ALI (CEO)
(614) 260-6617
Entity
Organization
Contact information
Practice address
6161 BUSCH BLVD STE 313, COLUMBUS, OH 43229-2555
(614) 947-1381
Mailing address
6161 BUSCH BLVD STE 313, COLUMBUS, OH 43229-2555
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
2547275
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291850
—
OH
Enumeration date
10/21/2010
Last updated
10/21/2010
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