Healthcare Provider Details

I. General information

NPI: 1962008508
Provider Name (Legal Business Name): MOORE CENTER SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2020
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 MCGREGOR STREET, UNIT 400
MANCHESTER NH
03102
US

IV. Provider business mailing address

195 MCGREGOR STREET, UNIT 400
MANCHESTER NH
03102
US

V. Phone/Fax

Practice location:
  • Phone: 603-206-2700
  • Fax: 603-792-8302
Mailing address:
  • Phone: 603-206-2700
  • Fax: 603-792-8302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHYE KING
Title or Position: COO
Credential:
Phone: 603-456-9752