MOONLIGHT HOME HEALTHCARE SERVICES, LLC (NPI# 1851781058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851781058 |
| Entity Type | Organization |
| Organization Name | MOONLIGHT HOME HEALTHCARE SERVICES, LLC |
| Practice Address |
2800 Selkirk Dr Apt 310c Burnsville MN 55337-5676 |
| Practice Telephone | 6513473096 |
| Mailing Telephone | 6513473096 |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2015-01-27 |
| Authorized Official Name | ASAD SALAH ABDALLE (ADMINISTRATOR) |
| Authorized Official Telephone | 6513473096 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WC0400X |
Registered Nurse Specialization: Case Management |
Nursing Service Providers | ||
| N | 163WH0200X |
Registered Nurse Specialization: Home Health |
Nursing Service Providers | ||
| Y | 163WA2000X |
Registered Nurse Specialization: Administrator |
Nursing Service Providers |
| Street Address |
2800 SELKIRK DR APT 310C |
| City | BURNSVILLE |
| State | MN |
| Zip Code | 55337-5676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939397 | Alpha Quality Care1 L. L. C. | Home Infusion | 12924 18th Ave South, Burnsville, MN 55337 | 2020-07-13 |
| 1568085900 | Kathryn Harris | Counselor | 11939 W. River Hills Dr., Burnsville, MN 55337 | 2020-05-20 |
| 1952941254 | Noah Home Care Inc. | Home Health | 13521 Nicollet Lane, Burnsville, MN 55337 | 2020-01-14 |
| 1750854287 | Baraka Home Care LLC | Nursing Care | 1700 James Place, Burnsville, MN 55337 | 2019-01-08 |
| 1699298778 | Raphael Cheron-dittmann | Hearing Instrument Specialist | 14000 Nicollet Ave. S., Suite 303, Burnsville, MN 55337 | 2017-07-20 |
| 1669909818 | Mercy Home Care Ltd | Hospice Care, Community Based | 1020 E 146th St Ste 220d, Burnsville, MN 55337 | 2017-05-18 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1730542572 | Iris Reproductive Psychiatric Clinic | Clinical Nurse Specialist | 1500 Mcandrews Road W, Ste 227, Burnsville, MN 55337 | 2016-03-30 |
| 1740657204 | Mercy Link, LLC | Home Health | 13005 Salem Pl, Burnsville, MN 55337 | 2015-08-31 |
| 1669852158 | Mixa Dipak Patel | Physical Therapy Assistant | 8380 Hiawatha Ave, Eden Prairie, MN 55337 | 2015-06-01 |
| Find all providers in zip 55337 | ||||
| Taxonomy Code | 163WA2000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Administrator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306243514 | Jessica Hensley | Registered Nurse | 202 Medical Campus Dr, Burnsville, NC 28714-9004 | 2014-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295368348 | Florence Home Care LLC | Registered Nurse | 1034 Adams St, Anoka, MN 55303-2620 | 2020-02-18 |
| 1245880723 | Hibo Ahmed | Registered Nurse | 351 93rd Ave Ne, Blaine, MN 55434-1230 | 2019-09-16 |
| 1760042253 | Adams Health Care Services, LLC | Registered Nurse | 10036 Washburn Ave S, Bloomington, MN 55431 | 2019-06-17 |
| 1336617398 | Shannon Wilson | Registered Nurse | 228 19th St Sw, Rochester, MN 55902-2327 | 2018-11-07 |
| 1326525726 | Megan Heuer Korhonen | Registered Nurse | 616 America Ave Nw Ste 130, Bemidji, MN 56601-3848 | 2018-07-27 |
| 1497265995 | My Legal Nurse Consultants LLC | Registered Nurse | 10608 Arrowhead St Nw, Coon Rapids, MN 55433-4013 | 2017-10-10 |
| 1881134716 | Laura Evenson | Registered Nurse | 61953 251st Ave, Mantorville, MN 55955-6039 | 2017-02-25 |
| 1093810244 | Grattan Health Care Incorporated | Registered Nurse | 5710 County Road 121, Fort Ripley, MN 56449-1486 | 2006-09-13 |
| 1427044239 | Janette Mary Setterquist | Registered Nurse | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2005-09-27 |
| 1467064402 | Pang Vang | Registered Nurse | 115 Magnolia Ave W, Saint Paul, MN 55117-4916 | 2020-08-20 |
| Find all providers with the same taxonomy | ||||
| City | BURNSVILLE |
| Zip Code | 55337 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.