Organization · Type 2 NPI

Mooreresidence Home, Inc

Mental Health Counselor · Jamaica, NY

NPI number 1154468015 Active

Practice location

16305 107th Ave, Suite 1R
Jamaica, NY 11433-2101

Call (718) 739-7420 Map

Fax (718) 487-3722

Mailing address

P.o. Box 650 439
Fresh Meadows, NY 11365

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X10889 (NY)
Mental Health Counselor Primary 101YM0800X003801-1 (NY)
Licensed Practical Nurse 164W00000X209905-1 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1154468015

Mooreresidence Home, Inc's National Provider Identifier is 1154468015, issued on Jan 31, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Jamaica, NY. The record was last updated on Sep 11, 2025.