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General NPI Number Information
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NPI Number | 1528597408
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Entity Type | Organization
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Legal Business Name | MOONLIGHT HOME HEALTHCARE, LLC
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2714 NE 42ND ST
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City | KANSAS CITY
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State | MO
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Zip | 64117-1604
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Country | US
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Telephone | 816-982-3353
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Fax |
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Provider Business Mailing Address
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Address Line | 2714 NE 42ND ST
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City | KANSAS CITY
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State | MO
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Zip | 64117-1604
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Country | US
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Telephone | 816-982-3353
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | HASSAN DAUD HUSSEIN
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Credential | BA
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Telephone | 816-982-3353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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