Provider Demographics
NPI:1891307963
Name:LR MOORE, LLC
Entity Type:Organization
Organization Name:LR MOORE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWANDA
Authorized Official - Middle Name:ROCHELLE
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-393-2525
Mailing Address - Street 1:5421 N 103RD ST STE 401
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1010
Mailing Address - Country:US
Mailing Address - Phone:402-393-2525
Mailing Address - Fax:402-393-2441
Practice Address - Street 1:5421 N 103RD ST STE 401
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-1010
Practice Address - Country:US
Practice Address - Phone:402-393-2525
Practice Address - Fax:402-393-2441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health