Organization · Type 2 NPI

Moonlight Convalescence Care LLC

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Houston, TX

NPI number 1124842687 Active

Practice location

11111 Bissonnet St Ste A
Houston, TX 77099-2045

Specialties and licenses

Taxonomy	Code	License
In Home Supportive Care Agency	253Z00000X	None listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	None listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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NPI record

NPI: 1124842687
Entity type: Organization (Type 2)
Issued: Nov 12, 2024
Last updated: Nov 12, 2024
Status: Active

Other names

Moonlight Convalescence Care LLC · doing business as
Moonlight Convalescence Care LLC · former legal business name

Authorized official

Dr. Wahab Olaiya Alabi
Co-Owner
(971) 348-1411

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About NPI 1124842687

Moonlight Convalescence Care LLC's National Provider Identifier is 1124842687, issued on Nov 12, 2024. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Houston, TX. The record was last updated on Nov 12, 2024.