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General NPI Number Information
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NPI Number | 1649443136
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Entity Type | Organization
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Legal Business Name | MOORE & ASSOCIATES, INC.
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 6530 SHERIDAN ROAD SUITE # 3
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City | KENOSHA
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State | WI
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Zip | 53143
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Country | US
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Telephone | 262-945-7266
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Fax | 262-605-1404
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Provider Business Mailing Address
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Address Line | 6530 SHERIDAN ROAD SUITE # 3
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City | KENOSHA
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State | WI
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Zip | 53143
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Country | US
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Telephone | 262-945-7266
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Fax | 262-605-1404
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. TONY CURTIS MOORE
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Credential | MS, ICS, CSAC
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Telephone | 262-945-7266
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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 | 2613
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License Number State | WI
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