Provider Demographics
NPI:1699108506
Name:MOONCAT LIVING, LLC
Entity type:Organization
Organization Name:MOONCAT LIVING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-924-7479
Mailing Address - Street 1:321 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:321 N CENTRAL EXPY
Practice Address - Street 2:SUITE 210
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3519
Practice Address - Country:US
Practice Address - Phone:214-924-7479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care