To the Moon & Back

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

TO THE MOON & BACK

Practice address

103 Kennedy Dr
Venus, TX 76084-1130

Phone

(937) 520-9206

NPI assigned

Mar 30, 2021

Organization subpart

No

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

Authorized official

Name

Jettah Hill

Title

Owner

Phone

(937) 520-9206

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1336727429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 KENNEDY DR",
            "city": "VENUS",
            "state": "TX",
            "postal_code": "760841130",
            "telephone_number": "937-520-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 KENNEDY DR",
            "city": "VENUS",
            "state": "TX",
            "postal_code": "760841130",
            "telephone_number": "937-520-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TO THE MOON & BACK",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-30",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "JETTAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-520-9206"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Venus, TX
• Providers in Venus, TX by specialty
• Adult Day Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.