Provider Demographics
NPI:1891366068
Name:THE MOORE CENTER DBA EATING RECOVERY CENTER DBA INSIGHT BEHAVIORAL HEA
Entity Type:Organization
Organization Name:THE MOORE CENTER DBA EATING RECOVERY CENTER DBA INSIGHT BEHAVIORAL HEA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING & CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-214-9321
Mailing Address - Street 1:1231 116TH AVE NE 3RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-214-9321
Mailing Address - Fax:
Practice Address - Street 1:1229 MADISON STREET #500
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:425-214-9321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE MOORE CENTER DBA EATING RECOVERY CENTER DBA INSIGHT BEHAVIORAL HEA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital