| Dr Moana, Llc | |
|
401 E Hillcrest Dr Dekalb IL 60115-2407 | |
| (773) 656-2738 | |
| Not Available |
| Full Name | Dr Moana, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 401 E Hillcrest Dr, Dekalb, Illinois |
| Authorized Official Name and Position | Joel Marc Filmore (OWNER/CEO) |
| Authorized Official Contact | 7736562738 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Moana, Llc 401 E Hillcrest Dr Dekalb IL 60115-2407 Ph: (773) 656-2738 | Dr Moana, Llc 401 E Hillcrest Dr Dekalb IL 60115-2407 Ph: (773) 656-2738 |
| NPI Number | 1003523366 |
|---|---|
| Provider Enumeration Date | 11/04/2022 |
| Last Update Date | 11/04/2022 |
| Certification Date | 11/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003523366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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