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Moonlight Support Services Llc
Adolescent and Children Mental Health Clinic/Center in Roseville, Minnesota
NPI 1164055026

Moonlight Support Services Llc is an Adolescent and Children Mental Health Clinic/Center based in Minneapolis, MN and is specialized in Adolescent and Children Mental Health. Moonlight Support Services Llc practices in Roseville, MN. The NPI Number for Moonlight Support Services Llc is 1164055026 and holds a License No. (Minnesota).

The current practice location address for Moonlight Support Services Llc is 3110 Old Hwy 8, Roseville, MN and can be reached out via phone at 602-323-4873.

Location: 3110 Old Hwy 8, Roseville, MN, 55419-2357
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164055026
Provider Name
Moonlight Support Services Llc
Credential
Provider Entity Type
Organization
Address
3110 Old Hwy 8, Roseville, MN, 55419-2357
Phone Number
602-323-4873
Fax Number
Provider Enumeration Date
02/19/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3110 Old Hwy 8
City
Roseville
State
Minnesota
Zip
55113-5511
Phone Number
602-323-4873
Fax Number
person
Provider Business Mailing Address Details
Address
3110 Old Hwy 8
City
Roseville
State
Minnesota
Zip
55113-5511
Phone Number
602-323-4873
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
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Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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