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Organization
MOORERESIDENCE HOME, INC
Active
Organization
MOORERESIDENCE HOME, INC
Active
Other names
Moore Residence Home, Inc. Multi Purpose center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA A MOORE MHS, LMHC (FOUNDER PRESIDENT)
(718) 739-7420
Entity
Organization
Contact information
Practice address
16305 107TH AVE, SUITE 1R, JAMAICA, NY 11433-2101
(718) 739-7420
(718) 487-3722
Mailing address
P.O. BOX 650 439, FRESH MEADOWS, NY 11365
(718) 739-7420
(718) 487-3722
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
10889
NY
101YM0800X
Mental Health Counselor
Primary
003801-1
NY
164W00000X
Licensed Practical Nurse
209905-1
NY
Other
Enumeration date
01/31/2007
Last updated
09/11/2025
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