NPIMap

Organization Active NPI

LJ Moore Incorporated

  • Developmentally Disabled Services Day Training Agency
  • Winston Salem, NC
National Provider Identifier
1275798522
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
1694956 Issued in NC
Legal business name
LJ MOORE INCORPORATED
Doing business as
Community Day Supports
Practice address
2306 Cragmore Rd
Winston Salem, NC 27107-2458
Phone
(336) 595-8760
NPI assigned
Jul 25, 2008
Organization subpart
Yes
Parent organization
LJ MOORE INCORPORATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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

Authorized official

Name
Carolyn Yvonnie Moore
Title
President
Phone
(336) 595-8760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 1694956 NC Primary

Addresses

Primary practice location

2306 Cragmore Rd
Winston Salem, NC 27107-2458

Mailing address

4743 Beacon Park LN
Walkertown, NC 27051-9220
Phone (336) 595-8760

Other names 1

  • Community Day Supports Doing business as

National Provider Directory

National Provider Directory
Tax ID family
LJ Moore Incorporated2 organizations share this tax ID, including this one
Part of
LJ Moore Incorporated

Other organizations with this tax ID 1

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

Locations

2306 Cragmore Rd
Winston Salem, NC 27107
Phone (336) 595-8760

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1275798522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4743 BEACON PARK LN",
            "city": "WALKERTOWN",
            "state": "NC",
            "postal_code": "270519220",
            "telephone_number": "336-595-8760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 CRAGMORE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271072458",
            "telephone_number": "336-595-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LJ MOORE INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LJ MOORE INCORPORATED",
        "enumeration_date": "2008-07-25",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "YVONNIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-595-8760"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "1694956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Day Supports",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.