Provider Demographics
NPI:1215020276
Name:MOONLITE HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:MOONLITE HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPT ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FARKHANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BILAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-538-9520
Mailing Address - Street 1:25941 W 6 MILE ROAD
Mailing Address - Street 2:SUITE E
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240
Mailing Address - Country:US
Mailing Address - Phone:313-538-9520
Mailing Address - Fax:313-538-9538
Practice Address - Street 1:25941 W 6 MILE RD
Practice Address - Street 2:SUITE E
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2214
Practice Address - Country:US
Practice Address - Phone:313-538-9520
Practice Address - Fax:313-538-9538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237539Medicare ID - Type Unspecified