Organization
MOORE FAMILY CARE HOME INC. # 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERNESTINE BONEY MOORE (ADMINISTRATOR)
(910) 289-7183
Entity
Organization
Contact information
Practice address
171 E CHARITY RD, ROSE HILL, NC 28458-8469
(910) 289-7183
(910) 289-3285
Mailing address
171 E CHARITY RD, ROSE HILL, NC 28458-8469
(910) 289-7183
(910) 289-3285
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
FCL-031-007
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
NC
Enumeration date
03/20/2007
Last updated
08/22/2020
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