Organization
MOOR OUT OF LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA ANAKWENZE MPH, MS (CEO)
(929) 324-0334
Entity
Organization
Contact information
Practice address
600 W MANCHESTER AVE STE 4, LOS ANGELES, CA 90044-5700
(929) 324-0334
Mailing address
600 W MANCHESTER AVE STE 4, LOS ANGELES, CA 90044-5700
(929) 324-0334
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
172V00000X
Community Health Worker
—
—
174H00000X
Health Educator
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
05/29/2020
Last updated
05/29/2020
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