Provider Demographics
NPI:1568273555
Name:7 MOONS WELLNESS
Entity type:Organization
Organization Name:7 MOONS WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TENEIL
Authorized Official - Middle Name:RACHELLE
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:307-351-1359
Mailing Address - Street 1:PO BOX 672
Mailing Address - Street 2:
Mailing Address - City:MILLS
Mailing Address - State:WY
Mailing Address - Zip Code:82644-0672
Mailing Address - Country:US
Mailing Address - Phone:307-351-1359
Mailing Address - Fax:
Practice Address - Street 1:1432 E 2ND ST UNIT A
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2961
Practice Address - Country:US
Practice Address - Phone:307-351-1359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care