Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Moonglade Integrative LLC

Organization Primary Care Clinic/Center · NPI 1568245595

Moonglade Integrative LLC is a Primary Care Clinic/Center in Grantsville, Maryland. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3233B Chestnut Ridge Rd
Grantsville, MD 21536-1370
Phone: (240) 321-2770
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1568245595
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Resh — Employee · (240) 321-2770
NPI enumeratedAugust 15, 2023
Last updated in NPPESFebruary 12, 2024
Certification dateFebruary 12, 2024
Mailing address300 Stiff Rd, Addison, PA 15411-2057

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