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General NPI Number Information
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NPI Number | 1538282439
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Entity Type | Organization
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Legal Business Name | THE MOOREHOUSE GROUP, INC.
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Dates
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Enumeration Date | 04/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1727 BLANDING BLVD SUITE 105
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City | JACKSONVILLE
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State | FL
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Zip | 32210-1962
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Country | US
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Telephone | 904-981-9881
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Fax | 904-981-9883
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Provider Business Mailing Address
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Address Line | 1727 BLANDING BLVD SUITE 105
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City | JACKSONVILLE
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State | FL
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Zip | 32210-1962
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Country | US
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Telephone | 904-981-9881
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Fax | 904-981-9883
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | TEDDY LEROY MOOREHOUSE
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Credential | MA, CAP, ICADC, SAP
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Telephone | 904-981-9881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | FL
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