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General NPI Number Information
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NPI Number | 1801829304
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Entity Type | Organization
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Legal Business Name | STEVEN A. MOORE
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 115 GRAND AVE
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City | SPENCER
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State | IA
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Zip | 51301-4224
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Country | US
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Telephone | 712-262-7838
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Fax | 712-262-0055
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Provider Business Mailing Address
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Address Line | 115 GRAND AVE
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City | SPENCER
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State | IA
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Zip | 51301-4224
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Country | US
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Telephone | 712-262-7838
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Fax | 712-262-0055
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Authorized Official
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Title or Position | OWNER
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Name | STEVE MOORE
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Credential |
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Telephone | 712-336-0999
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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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