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Organization
MOORE HOME
Active
Organization
MOORE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK A MOORE (ADMINISTRATOR)
(910) 353-9328
Entity
Organization
Contact information
Practice address
232 NEWPORT DR, JACKSONVILLE, NC 28540-4005
(910) 353-9328
Mailing address
232 NEWPORT DR, PO BOX 12541, JACKSONVILLE, NC 28540-4005
(910) 353-9328
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-147
NC
Other
Enumeration date
02/22/2007
Last updated
08/22/2020
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