Healthcare Provider Details

I. General information

NPI: 1396031480
Provider Name (Legal Business Name): MOVING FORWARD ENHANCE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 LANCASTER STREEET
ROCKY MOUNT NC
27802-0213
US

IV. Provider business mailing address

907 LANCASTER STREET
ROCKY MOUNT NC
27801
US

V. Phone/Fax

Practice location:
  • Phone: 252-210-3089
  • Fax: 252-210-3089
Mailing address:
  • Phone: 252-210-3089
  • Fax: 252-210-3089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: MR. CURTIS M JONES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 252-210-3089