TAVARIUS JERRELL MOORE

BURLINGTON, NC
NPI1104384262
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy311ZA0620X Custodial Care Facility Adult Care Home
(Licence: NC  FCL-001-107)
Enumeration Date2019-03-07
Last Update Date2019-03-07
Business Address
TAVARIUS JERRELL MOORE
206 FRIENDLY RD
BURLINGTON, NC 27217-2502
Phone number: 804-624-3515
Mailing Address
TAVARIUS JERRELL MOORE
206 FRIENDLY RD
BURLINGTON, NC 27217-2502
Phone number: 804-624-3515
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