Provider Demographics
| NPI: | 1871659201 |
|---|---|
| Name: | MOORE CENTER SERVICES, INC. |
| Entity Type: | Organization |
| Organization Name: | MOORE CENTER SERVICES, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO/VP |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | DENISE |
| Authorized Official - Middle Name: | CAROLINE |
| Authorized Official - Last Name: | DOUCETTE |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 603-206-2700 |
| Mailing Address - Street 1: | 132 TITUS AVE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MANCHESTER |
| Mailing Address - State: | NH |
| Mailing Address - Zip Code: | 03103-6695 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 603-668-5423 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 195 MCGREGOR ST STE 400 |
| Practice Address - Street 2: | |
| Practice Address - City: | MANCHESTER |
| Practice Address - State: | NH |
| Practice Address - Zip Code: | 03102-3779 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 603-206-2792 |
| Practice Address - Fax: | 603-622-4278 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-12-29 |
| Last Update Date: | 2023-06-14 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 235500000X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Group - Multi-Specialty | |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
| No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | Group - Multi-Specialty | |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | Group - Multi-Specialty |
| No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NH | 3139966 | Medicaid | |
| NH | 99590027 | Medicaid | |
| NH | 3073399 | Medicaid | |
| NH | 3077305 | Medicaid | |
| NH | 60000007 | Medicaid | |
| NH | 99590007 | Medicaid | |
| NH | 3081129 | Medicaid | |
| NH | 99560007 | Medicaid | |
| NH | 3072381 | Medicaid | |
| NH | 3081128 | Medicaid | |
| NH | 99560057 | Medicaid |
