Organization
DAVID MOORE JR
Active
Other names
Moores House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MOORE JR. (OWNER)
(919) 632-9219
Entity
Organization
Contact information
Practice address
3108 DEARBORN DR, DURHAM, NC 27704-2306
(919) 632-9219
Mailing address
3108 DEARBORN DR, DURHAM, NC 27704
(919) 632-9219
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
MHL-032-304
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805024
—
NC
Enumeration date
04/13/2007
Last updated
06/25/2008
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