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General NPI Number Information
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NPI Number | 1346612413
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Entity Type | Organization
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Legal Business Name | ERICA MOORE
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/28/2015
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Provider Practice Location Address
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Address Line | 123 N HARTFORD AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44509
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Country | US
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Telephone | 330-720-9699
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Fax |
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Provider Business Mailing Address
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Address Line | 123 N HARTFORD AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44509-2321
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Country | US
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Telephone | 330-720-9699
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Fax |
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Authorized Official
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Title or Position | NON AGENCY PERSONAL CARE AIDE
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Name | ERICA M MOORE
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Credential |
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Telephone | 330-720-9699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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