Healthcare Provider Details

I. General information

NPI: 1225940752
Provider Name (Legal Business Name): MOORE COMMUNITY CARE & SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 VIKING DR
INDEPENDENCE MO
64057-1330
US

IV. Provider business mailing address

2405 VIKING DR
INDEPENDENCE MO
64057-1330
US

V. Phone/Fax

Practice location:
  • Phone: 816-466-0000
  • Fax:
Mailing address:
  • Phone: 816-466-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MYZSA MOORE
Title or Position: OWNER/OPERATOR
Credential:
Phone: 816-466-0000