MEDICARE: MOOREHOUSE B&C SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1073991642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOOREHOUSE B&C SERVICES

Provider Business Mailing Address
First Line	:	7340 ELDERLY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-3223
Country	:	US
Telephone Number	:	702-647-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	7340 ELDERLY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-3223
Country	:	US
Telephone Number	:	702-647-4700
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. LILLIAN MOORE
Credential	:
Telephone Number	:	702-677-4700

Provider Enumeration Date	:	05/14/2015
Last Update Date	:	05/14/2015

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Directions to “MOOREHOUSE B&C SERVICES ” Practice Location

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