RC Moore Sil

Primary specialty

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

License

SIL 8083 Issued in LA

Legal business name

RC MOORE SIL

Practice address

200 S Alvin St
Bastrop, LA 71220-4105

Phone

(318) 281-4889

Fax

(318) 281-4891

NPI assigned

Apr 18, 2007

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

RC Moore Respite Pca2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• RC Moore Respite & Pca

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bastrop, LA
  • NPI 1881819852
  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": "1265658934",
    "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": "318-281-4889",
            "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": "318-281-4889",
            "fax_number": "318-281-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RC MOORE SIL",
        "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": "SIL 8083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1543420",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeisha Qualls
• Mary Webster Rachal, D.D.S.
• Deborah Ray
• Stephanie Razon, MOT/LOTR
• RC Moore Respite & Pca
• Brooklyn Rea, MS CCC-SLP
• Valencia Reese
• Resilient Solutions
• Kia Rhodes
• Richard R. Russell, O.D.

• 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.