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Contact Information

HOLLY S MOORE, MSOTR/L
202 WEST DAVENPORT STREET
CROSSVILLE, IL62827
 Phone: 618-928-4801
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for

NPI Number 1255648390
Entity Organization
Organization subpart 1 Not specified
Enumeration date 09/10/2010
Last updated 09/10/2010 - About 16 years ago
Identifiers
IL License # 056.008560
IN License # 31004566A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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