Healthcare Provider Details

I. General information

NPI: 1669288676
Provider Name (Legal Business Name): MOORE HEALING & EMPOWERMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1773 RALEIGH CT W
OCEAN NJ
07712-2600
US

IV. Provider business mailing address

1773 RALEIGH CT W APT 9B
OCEAN NJ
07712-2628
US

V. Phone/Fax

Practice location:
  • Phone: 732-654-2954
  • Fax:
Mailing address:
  • Phone: 973-600-4975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: IRENA MOORE
Title or Position: OWNER
Credential:
Phone: 973-600-4975