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General NPI Number Information
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NPI Number | 1528682283
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Entity Type | Organization
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Legal Business Name | MOOR OUT OF LIFE
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Dates
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Enumeration Date | 05/29/2020
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Last Update Date | 05/29/2020
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Provider Practice Location Address
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Address Line | 600 W MANCHESTER AVE STE 4
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City | LOS ANGELES
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State | CA
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Zip | 90044-5700
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Country | US
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Telephone | 929-324-0334
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Fax |
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Provider Business Mailing Address
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Address Line | 600 W MANCHESTER AVE STE 4
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City | LOS ANGELES
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State | CA
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Zip | 90044-5700
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Country | US
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Telephone | 929-324-0334
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. LISA ANAKWENZE
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Credential | MPH, MS
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Telephone | 929-324-0334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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