MRS. STACEY BRIGHAM MOORE (NPI# 1558872341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558872341 |
| Entity Type | Individual |
| Full Name | MRS. STACEY BRIGHAM MOORE |
| Practice Address |
4321 Nw State Road 270 Bristol FL 32321-2303 |
| Practice Telephone | 8505672095 |
| Mailing Telephone | 8505672095 |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2017-10-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| Y | 251C00000X | Day Training, Developmentally Disabled Services | DC | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184153553 | Stacey Hurst Moore | Counselor | 4020 Richards Rd Ste F, North Little Rock, AR 72117-2744 | 2017-06-08 |
| 1386075331 | Stacey Moore | Dietitian, Registered | 5124 Roemer Lane, Sacramento, CA 95820-3033 | 2013-12-02 |
| 1942310404 | Stacey Moore | Pharmacist | 2418 Sylvester Rd, Albany, GA 31705-2468 | 2006-08-30 |
| 1265085237 | Stacey Moore | Social Worker | 719 Thompson Ln Ste 30330, Nashville, TN 37204-4701 | 2019-07-18 |
| 1457837452 | Stacey D Moore | Dental Hygienist | 6850 Upper Box Elder Rd, Box Elder, MT 59521-9073 | 2018-07-13 |
| 1184079873 | Stacey Marie Moore | Counselor | 1509 Maple St, Scranton, PA 18505-2707 | 2016-04-29 |
| 1174913297 | Stacey Moore | Massage Therapist | 440 Columbia Blvd, Saint Helens, OR 97051-1910 | 2015-01-27 |
| 1982887493 | Stacey Denise Moore | Surgery | 1550 First Colony Blvd, Sugar Land, TX 77479-4000 | 2007-12-07 |
| 1225210206 | Stacey L Moore | Counselor | 1220 Dewey Ave, Wauwatosa, WI 53213-2504 | 2007-11-30 |
| 1275684268 | Stacey J Moore | Registered Nurse | 1955 Dixie Hwy, Ste C, Ft Wright, KY 41011-2792 | 2007-01-16 |
| Street Address |
4321 NW STATE ROAD 270 |
| City | BRISTOL |
| State | FL |
| Zip Code | 32321-2303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649739194 | Amberly Portero | Counselor | 10611 Florida Highway 20, Bristol, FL 32321 | 2019-03-14 |
| 1194281121 | Ash Bailey Smith | Social Worker | 10659 Nw Sr 20, Bristol, FL 32321 | 2019-02-14 |
| 1508295692 | Maggie Chavez | Counselor | 12422 Ne Revell Road, Bristol, FL 32321 | 2013-11-08 |
| 1437586609 | Queen Brown Haven Assisted Living Facility | Assisted Living Facility | 6906 Nw Torreya Park Road, Bristol, FL 32321 | 2013-10-03 |
| 1538400072 | Ruby Lee Varnum | Assisted Living Facility | 12167 Nw Freeman Rd, Bristol, FL 32321 | 2013-03-08 |
| 1417233321 | April Dawn Landrum | Case Management | 13888 Nw Cr 12, Apalachee Center, Inc., Bristol, FL 32321 | 2011-10-25 |
| 1417191107 | Elizabeth Stephanie Hofrichter | Social Worker | 11033 Nw Sr 20, Bristol, FL 32321 | 2009-04-24 |
| 1275734881 | Efren L Baltazar | Obstetrics & Gynecology | 2571 Executive Center Circle East, Howard Building Division of Disability Determination, Tallahassee, FL 32321 | 2007-05-30 |
| 1336260322 | Laban Bontrager | Dentist | 12761 Ne Pea Ridge Rd, Bristol, FL 32321 | 2007-04-03 |
| 1225192404 | Liberty County School Board | Local Education Agency (LEA) | 12926 Nw Cr 12, Bristol, FL 32321 | 2006-12-21 |
| Find all providers in zip 32321 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265943286 | Deidra L Bess | Day Training, Developmentally Disabled Services | 4362 Nw State Road 270, Bristol, FL 32321-2310 | 2017-10-17 |
| 1972638468 | Living In Fulfilling Environments, Inc. | Day Training, Developmentally Disabled Services | 490 Metacom Ave, Suite 2, Bristol, RI 02809-5167 | 2007-02-23 |
| 1184777997 | Adec Inc | Day Training, Developmentally Disabled Services | 19670 State Road 120, Bristol, IN 46507-9131 | 2007-01-18 |
| 1922164599 | Frontier Health | Day Training, Developmentally Disabled Services | 498 Industrial Dr, Bristol, TN 37620-5400 | 2006-12-28 |
| 1558544304 | Adec Inc | Day Training, Developmentally Disabled Services | 19670 State Road 120, Bristol, IN 46507-9131 | 2007-12-14 |
| 1134256530 | Living In Fulfilling Environments, Inc. | Day Training, Developmentally Disabled Services | 490 Metacom Ave, Suite 6, Bristol, RI 02809-5167 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528361 | Where The Heart Is Home Care Services LLC | Day Training, Developmentally Disabled Services | 110 E Broad St Apt 204, Tampa, FL 33604-4132 | 2020-11-04 |
| 1801496674 | Brandon Martinez | Day Training, Developmentally Disabled Services | 1884 Sw 81st Way, Davie, FL 33324-4609 | 2020-10-29 |
| 1639779721 | The Unique Way LLC | Day Training, Developmentally Disabled Services | 1025 S Ohio Ave Apt 15, Lakeland, FL 33803-1283 | 2020-10-28 |
| 1821696394 | Devotion of Care LLC | Day Training, Developmentally Disabled Services | 1801 Nw 3rd St, Pompano Beach, FL 33069-2756 | 2020-10-15 |
| 1538767298 | Healthy Group Home Project, LLC. | Day Training, Developmentally Disabled Services | 849 Mulberry Ave, Panama City, FL 32401-2556 | 2020-10-15 |
| 1902404742 | Brite Life Adult Training Program, LLC | Day Training, Developmentally Disabled Services | 1300 Nw 95th St, Miami, FL 33147-3320 | 2020-10-14 |
| 1134727845 | Four Seasons Aba | Day Training, Developmentally Disabled Services | 6 Meridian Home Ln, Palm Coast, FL 32137-2402 | 2020-10-14 |
| 1760089429 | Helping Angels Thrive, Inc. | Day Training, Developmentally Disabled Services | 305 Providence Rd Apt 101, Brandon, FL 33511-4739 | 2020-10-06 |
| 1245847268 | Joshua R Grant | Day Training, Developmentally Disabled Services | 2405 Almeda St, Jacksonville, FL 32209-4632 | 2020-09-24 |
| 1417562257 | Peace of Mind Home Care Services | Day Training, Developmentally Disabled Services | 1102 Ray Charles Blvd Unit 314, Tampa, FL 33602-3050 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.