Provider Demographics
NPI:1619621638
Name:THE MOORE THE MERRIER, INC.
Entity Type:Organization
Organization Name:THE MOORE THE MERRIER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AFH PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:PN
Authorized Official - Phone:360-308-9305
Mailing Address - Street 1:8004 NEWBERRY PL NW
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-1068
Mailing Address - Country:US
Mailing Address - Phone:360-308-9305
Mailing Address - Fax:
Practice Address - Street 1:8004 NEWBERRY PL NW
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-1068
Practice Address - Country:US
Practice Address - Phone:360-308-9305
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2012-77956Medicaid
WA750038OtherDSHS ADULT FAMILY HOME LICENSE
WALP00044661OtherBOARD OF NURSING NCSBN ID: 2175016