W I Moore INC

NPI #1952527756 in Bastrop, Louisiana

Provider Information

NPI Number: 1952527756
Entity Type: Organization
Organization Name: W I Moore INC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 18, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 200 S ALVIN ST
City: Bastrop
State: Louisiana
ZIP Code: 71220-4105
Phone: (318) 281-4889

Authorized Official

Name: MR. DAVID E SMITH
Title: EXECUTIVE DIRECTOR
Phone: (318) 281-4889

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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