Moon River, Llc

LBN: Moon River, Llc
Moon River, Llc is an health care organization with primary practice located at 790 Oak Trail Dr , Marietta GA 30062-7502. The organization recently has 4 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is the primary health care specialty. Moon River, Llc can be contacted via phone (770) 977-6866, or through Smith, Maria Teresa via phone (770) 977-6866.

Contact Information

Primary practice address
790 Oak Trail Dr Marietta GA 30062-7502
Phone: (770) 977-6866
Fax: (770) 977-6887
Website:
Map and Directions
Authorized official contact:
Name: Smith, Maria Teresa
Phone: (770) 977-6866

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT003833 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT008523 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT008507 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT001355 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT007864 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT005771 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT008924 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT004577 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OT 004293 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X GAOT001717 Georgia
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP003992 Georgia
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP005806 Georgia
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP006528 Georgia
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP 06551 Georgia
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP 006556 Georgia

Profile Details

NPI number 1730143553
LBN Legal business name Moon River, Llc
DBA Doing business as
Authorized official Smith, Maria Teresa
Entity Organization
Organization subpart 1 No
Enumeration date Apr 17th, 2006
Last updated Feb 15th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730143553 NPPES
Georgia MEDICAID 191707573A
Georgia MEDICAID 240960806A
Georgia MEDICAID 516643175A
Georgia MEDICAID 761415888A
Georgia MEDICAID 814363142A
Georgia MEDICAID 000860736B
Georgia MEDICAID 146855825A
Georgia MEDICAID 765677599A
Georgia MEDICAID 188883028B
Georgia MEDICAID 317872221A
Georgia MEDICAID 339518223A
Georgia MEDICAID 426315361A
Georgia MEDICAID 986209149B
Georgia MEDICAID 000970835A
Georgia MEDICAID 481436178B
Georgia MEDICAID 503885675B
Georgia MEDICAID 850524466A
Georgia MEDICAID 315889908A
Georgia MEDICAID 000753563E
Georgia MEDICAID 461168837A

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