Moonlight Support Services LLC
Moonlight Support Services LLC is an Adolescent and Children Mental Health Clinic/Center in Roseville, Minnesota. Registered with an NPI since 2020.
- In the registry since
- 2020
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
3110 Old Hwy 8 206Roseville, MN 55113-5511
Phone: (602) 323-4873
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Adolescent and Children Mental Health Clinic/Center (primary) | Taxonomy 261QM0855X |
|---|
Record details
| NPI number | 1164055026 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Abdirazaq Ibrahim — Owner · (602) 323-4873 |
| NPI enumerated | February 19, 2020 |
| Last updated in NPPES | February 19, 2020 |
| Certification date | February 19, 2020 |
| Mailing address | 5913 Pleasant Ave Ste 104, Minneapolis, MN 55419-2357 |