Organization Name: | MOORE PROFESSIONAL CHILDCARE AND LEARNING CENTER |
NPI Number: | 1093018830 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHAWNTINA MOORE (ADMINISTRATOR) |
Mailing Address: | 3032 140th Pl Blue Island |
State: | IL US |
Postal Code: | 604063357 |
Phone Number: | 8772327242 |
Fax Number: | 8772327242 |
NPI Enumeration Date: | 12/17/2010 |
NPI Last Update Date: | 06/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | 056.008266 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |