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General NPI Number Information
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NPI Number | 1881353589
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Entity Type | Organization
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Legal Business Name | MOVING FORWARD HOME ENTERPRISE
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Dates
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Enumeration Date | 12/10/2021
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 1 LMU DR MSB 12029
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City | LOS ANGELES
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State | CA
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Zip | 90045
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Country | US
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Telephone | 504-312-3826
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 AVIATION BLVD # 504
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City | REDONDO BEACH
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State | CA
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Zip | 90278-2805
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Country | US
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Telephone | 504-312-3826
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. EARL TURNER III
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Credential | MA
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Telephone | 504-312-3826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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