Organization
MOORE BOUTIQUE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALTHEA MOORE LACHICOTTE RN; JD (MANAGING MEMBER)
(904) 246-7267
Entity
Organization
Contact information
Practice address
1825 3RD ST N STE B, JACKSONVILLE BEACH, FL 32250-4840
(904) 372-4534
Mailing address
PO BOX 26087, JACKSONVILLE, FL 32226-6087
(904) 334-1293
(904) 757-6528
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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