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General NPI Number Information
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NPI Number | 1568273555
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Entity Type | Organization
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Legal Business Name | 7 MOONS WELLNESS
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 1432 E 2ND ST UNIT A
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City | CASPER
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State | WY
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Zip | 82601-2961
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Country | US
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Telephone | 307-351-1359
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 672
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City | MILLS
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State | WY
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Zip | 82644-0672
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Country | US
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Telephone | 307-351-1359
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. TENEIL RACHELLE SULLIVAN
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Credential | RN
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Telephone | 307-351-1359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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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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