Moore, James Eddie

Moore, James Eddie is an individual health care provider with primary practice located at 2319 W Capitol Dr , Milwaukee WI 53206-1919. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Moore, James Eddie can be contacted via phone (414) 744-5370.

Contact Information

Primary practice address
2319 W Capitol Dr Milwaukee WI 53206-1919
Phone: (414) 744-5370
Fax: (414) 744-9052
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 2041 Wisconsin

Profile Details

NPI number 1427194877
LBN Legal business name Moore, James Eddie
Credentials CADC-III
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated Mar 16th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427194877 NPPES
Wisconsin MEDICAID 39369400

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