| Blue Moon Senior Counseling, Llc. | |
|
900 Ne 18th Ave Apt 1207 Fort Lauderdale FL 33304-3054 | |
| (630) 844-7077 | |
| Not Available |
| Full Name | Blue Moon Senior Counseling, Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 900 Ne 18th Ave Apt 1207, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Melanie Donohue (OWNER) |
| Authorized Official Contact | 8552417160 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Moon Senior Counseling, Llc. 900 Ne 18th Ave Apt 1207 Fort Lauderdale FL 33304-3054 Ph: (630) 844-7077 | Blue Moon Senior Counseling, Llc. 900 Ne 18th Ave Apt 1207 Fort Lauderdale FL 33304-3054 Ph: (630) 844-7077 |
| NPI Number | 1245588441 |
|---|---|
| Provider Enumeration Date | 08/17/2012 |
| Last Update Date | 08/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245588441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SW10454 (Florida) | Primary |
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