Provider Demographics
NPI:1003081407
Name:CATHY E. MOORE'S RESPITE CARE & PCA SERVICES, INC.
Entity Type:Organization
Organization Name:CATHY E. MOORE'S RESPITE CARE & PCA SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-278-2922
Mailing Address - Street 1:PO BOX 79
Mailing Address - Street 2:
Mailing Address - City:VIOLET
Mailing Address - State:LA
Mailing Address - Zip Code:70092-0079
Mailing Address - Country:US
Mailing Address - Phone:504-278-2922
Mailing Address - Fax:504-278-2923
Practice Address - Street 1:2626 CHARLES DR STE G
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-3779
Practice Address - Country:US
Practice Address - Phone:504-278-2922
Practice Address - Fax:504-279-2923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1542571Medicaid