Provider Demographics
NPI:1386780260
Name:MOORES RESPITE CARE & PCA SERVICES
Entity type:Organization
Organization Name:MOORES RESPITE CARE & PCA SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-682-9882
Mailing Address - Street 1:PO BOX 79
Mailing Address - Street 2:
Mailing Address - City:VIOLET
Mailing Address - State:LA
Mailing Address - Zip Code:70092-0079
Mailing Address - Country:US
Mailing Address - Phone:504-682-9882
Mailing Address - Fax:504-682-9881
Practice Address - Street 1:6201 E SAINT BERNARD HWY
Practice Address - Street 2:SUITE D
Practice Address - City:VIOLET
Practice Address - State:LA
Practice Address - Zip Code:70092-3458
Practice Address - Country:US
Practice Address - Phone:504-682-9882
Practice Address - Fax:504-682-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10049251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1190632Medicaid
LA1542571Medicaid
LA1103799Medicaid