NPI: 1154468015
Provider Name: MOORERESIDENCE HOME, INC
Other Name: MOORE RESIDENCE HOME, INC. MULTI PURPOSE CENTER
Classification: Counselor - 101YA0400X
Entity Type: Organization
Specialization: Addiction (Substance Use Disorder)
Address:
16305 107TH AVE
SUITE 1R
JAMAICA, NY
ZIP 11433
Phone: (718) 739-7420
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MOORERESIDENCE HOME, INC is an addiction (substance use disorder) counselor in Jamaica, NY. MOORERESIDENCE HOME, INC NPI is 1154468015. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Moore Residence Home, Inc. Multi Purpose Center.
The provider's business location address is:
16305 107TH AVE
SUITE 1R
JAMAICA, NY
ZIP 11433-101
Phone: (718) 739-7420
Fax: (718) 487-3722
The provider's authorized official is Donna A Moore .
The authorized official title is FOUNDER PRESIDENTPresident and has the following contact phone number (718) 739-7420.
The enumeration date for this NPI number is 1/31/2007 and was last updated on 8/22/2020.