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General NPI Number Information
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NPI Number | 1588465884
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Entity Type | Organization
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Legal Business Name | MOORE WELLNESS AND CARE SOLUTIONS, LLC
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Dates
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Enumeration Date | 03/22/2025
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Last Update Date | 03/22/2025
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Provider Practice Location Address
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Address Line | 1680 44TH ST SE UNIT 8253
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City | GRAND RAPIDS
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State | MI
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Zip | 49518-5013
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Country | US
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Telephone | 616-375-8836
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Fax | 616-288-2990
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Provider Business Mailing Address
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Address Line | 1680 44TH ST SE UNIT 8253
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City | GRAND RAPIDS
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State | MI
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Zip | 49518-5013
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Country | US
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Telephone | 616-375-8836
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Fax | 616-288-2990
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Authorized Official
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Title or Position | OWNER/CLINICAL COORDINATOR
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Name | MRS. KENDRA SMITH
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Credential | LPN
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Telephone | 616-375-8836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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