Moore Home

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

MHL-147 Issued in NC

Legal business name

MOORE HOME

Practice address

232 Newport Dr
Jacksonville, NC 28540-4005

Phone

(910) 353-9328

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Rick A Moore

Title

Administrator

Phone

(910) 353-9328

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639204233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NEWPORT DR",
            "address_2": "PO BOX 12541",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404005",
            "telephone_number": "910-353-9328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 NEWPORT DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404005",
            "telephone_number": "910-353-9328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-353-9328",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M H FACILITY LICENSE#",
            "identifier": "MHL-147",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409541",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Monroe
• Joseph Monroe
• Felix Montesino
• Summer Monzon
• James Edmond Moody, PHARMD
• Jessica Theresa Moore-Tyson, LPC
• Abigail Faith Moore, OTR/L
• Brandi Moore, NP
• Brittany Moore
• Candace McInnis Moore, NP-C

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• 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.