Organization Name: | MOONSTONE INC |
NPI Number: | 1396022695 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHRYN ANNE MASON (PRESIDENT) |
Mailing Address: | 377 N Main St Plainwell |
State: | MI US |
Postal Code: | 490801368 |
Phone Number: | 2696858329 |
Fax Number: | |
NPI Enumeration Date: | 11/15/2011 |
NPI Last Update Date: | 11/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 385H00000X |
License Number: | AF030093563 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Respite Care Facility |
Taxonomy Classification: | Respite Care |
Taxonomy Specialization: | |
Taxonomy Definition: |