Provider Demographics
NPI:1265154223
Name:MOORE COUNSELING & MEDIATION SERVICES
Entity type:Organization
Organization Name:MOORE COUNSELING & MEDIATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTAKE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:PERKEY
Authorized Official - Suffix:
Authorized Official - Credentials:CASE MANAGER/ INTAKE
Authorized Official - Phone:216-404-1900
Mailing Address - Street 1:1909 E 123RD ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1940
Mailing Address - Country:US
Mailing Address - Phone:443-453-8752
Mailing Address - Fax:
Practice Address - Street 1:22639 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1622
Practice Address - Country:US
Practice Address - Phone:216-404-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management