NPI 1073997508

Delena Renee Moore

Practitioner Intellectual and/or Developmental Disabilities Residential Treatment Facility Kalamazoo, MI

Practice location

Address: 722 N Edwards St, Kalamazoo, MI 49007-3505
Phone: (269) 363-6137

Registered specialties (2)

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence AS390367863 (MI)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Michigan →

Physical Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320700000X Licence AS390367863 (MI)

Other Residential Treatment Facility, Physical Disabilities providers in Michigan →

Registry record

NPI: 1073997508
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Jul 2015
Record last updated: 15 Jul 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.