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Organization

MOORE HOUSE, INC

Active
Other names
Moore House
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MIRANDA FRAZIER (ASSISTANT CHIEF ADMINISTRATIVE OFFI)
(757) 966-1622
Entity
Organization

Contact information

Practice address
3608 KING ST, PORTSMOUTH, VA 23707-3128
(757) 966-1622
(757) 966-2802
Mailing address
4211 COUNTY STREET, ATTN: BUSINESS OFFICE, PORTSMOUTH, VA 23707-3128
(757) 397-6352

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Enumeration date
05/19/2022
Last updated
05/19/2022
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