Wimoore Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

633 Issued in LA

Legal business name

WIMOORE INC

Practice address

200 S Alvin St
Bastrop, LA 71220-4105

Phone

(318) 218-4889

Fax

(318) 281-4891

NPI assigned

Apr 18, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David E Smith

Title

Executive Director

Phone

(318) 281-4889

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

W I Moore Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• W I Moore Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bastrop, LA
  • NPI 1952527756
  NPD tax ID
• W.I. Moore Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bastrop, LA
  • NPI 1659596740
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023234820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S ALVIN ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712204105",
            "telephone_number": "318-218-4889",
            "fax_number": "318-281-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ALVIN ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712204105",
            "telephone_number": "318-218-4889",
            "fax_number": "318-281-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIMOORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "318-281-4889",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1718921",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Kathryn Wilkerson, SLP
• Shayne Willard
• Alvin T Williams
• Jamie Williams
• Toni Williams
• Cedric Winston Jr.
• Ingrid Winston
• Tangela Witherspoon
• Wonderful Care Services LLC
• Daniel W Wood, PHYSICAL THERAPIST

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Bastrop, LA
• Providers in Bastrop, LA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.