Healthcare Provider Details

I. General information

NPI: 1821992447
Provider Name (Legal Business Name): LUNA CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 GLADSTONE LOOP
CLAYTON NC
27520-4866
US

IV. Provider business mailing address

5709 PREVEZA PL
RALEIGH NC
27603-8172
US

V. Phone/Fax

Practice location:
  • Phone: 919-777-8435
  • Fax:
Mailing address:
  • Phone: 919-777-8435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: LINA EL HASAN
Title or Position: OWNER
Credential:
Phone: 919-777-8435