Sully Moon, IP is an attendant care provider technician in Liberty Lake, WA. The provider is an individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law. Sully Moon, IP NPI is 1982326914. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
1410 N CAUFIELD CT
LIBERTY LAKE, WA
ZIP 99016-433
Phone: (360) 525-5996
The enumeration date for this NPI number is 9/15/2022 and was last updated on 9/15/2022.