Moonlight Support Services LLC

Moonlight Support Services LLC is a healthcare organization registered as Adolescent and Children Mental Health Clinic/Center in Roseville, MN, holding Type 2 (organization) NPI 1164055026 since 2020. The authorized official on file is Abdirazaq Ibrahim, Owner.

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NPI	1164055026
Entity type	Organization (Type 2)
Legal business name	Moonlight Support Services LLC
Practice address	3110 OLD HWY 8, 206, Roseville, MN, 55113
Phone	6023234873
Enumeration date	2020-02-19
Last updated in NPPES	2020-02-19

Authorized official

Name	Abdirazaq Ibrahim
Title	Owner
Phone	6023234873

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
261QM0855X	Adolescent and Children Mental Health Clinic/Center	Primary	—	—

Copy-ready billing details

Provider: Moonlight Support Services LLC
NPI: 1164055026
Taxonomy: 261QM0855X (Adolescent and Children Mental Health Clinic/Center)
Address: 3110 OLD HWY 8, 206, Roseville, MN, 55113

Verify this record

Cross-check NPI 1164055026 against the authoritative CMS record: view Moonlight Support Services LLC on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Moonlight Support Services LLC located?

The practice location on file with NPPES is in Roseville, MN.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-02-19. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-02-19.