Provider Demographics
NPI:1083930549
Name:KATHERINE CLAY MOSS, INC.
Entity Type:Organization
Organization Name:KATHERINE CLAY MOSS, INC.
Other - Org Name:SENIOR HELPER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BLACKMON-OXLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-270-1770
Mailing Address - Street 1:499 NE SPANISH RIVER BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4503
Mailing Address - Country:US
Mailing Address - Phone:561-395-3818
Mailing Address - Fax:561-395-3819
Practice Address - Street 1:499 NE SPANISH RIVER BLVD STE 6
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4503
Practice Address - Country:US
Practice Address - Phone:561-395-3818
Practice Address - Fax:561-395-3819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health