Moonlight Healthcare Series LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

MOONLIGHT HEALTHCARE SERIES LLC

Practice address

3700 Grifbrick Dr
Plano, TX 75075-1514

Phone

(469) 733-8622

Fax

(469) 965-9401

NPI assigned

Nov 7, 2020

Last updated

Nov 7, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Olusegun B Abejide

Title

Owner

Phone

(469) 733-8622

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604707200000",
    "number": "1174124820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 GRIFBRICK DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750751514",
            "telephone_number": "469-733-8622",
            "fax_number": "469-965-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 GRIFBRICK DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750751514",
            "telephone_number": "469-733-8622",
            "fax_number": "469-965-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONLIGHT HEALTHCARE SERIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-07",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A",
        "authorized_official_last_name": "ABEJIDE",
        "authorized_official_first_name": "OLUSEGUN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-733-8622"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Moon III, M.D.
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• Aaron Moore, BCBA
• Austin Moore, DO
• Christine C Moore, DC

• In Home Supportive Care Agency in Plano, TX
• Providers in Plano, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.