TAVARIUS JERRELL MOORE
NPI 1104384262
Custodial Care Facility - Adult Care Home in Burlington, NC

Active since March 07, 2019
206 FRIENDLY RD, BURLINGTON, NC 27217(804) 624-3515 Get Directions Write a Review

NPPES record last updated: March 7, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tavarius Jerrell Moore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAVARIUS JERRELL MOORE (NPI 1104384262) is an individual adult care home provider in Burlington, North Carolina, licensed in North Carolina (FCL-001-107) and active in the NPI registry since March 2019.

NPPES Registry Identity

NPI1104384262
Entity TypeIndividualMale
Primary Taxonomy311ZA0620X
Provider Legal NameTAVARIUS JERRELL MOORE
Location Address206 FRIENDLY RDBurlington, NC 27217-2502
Mailing Address206 Friendly RdBurlington, NC 27217-2502 · (804) 624-3515
Sole ProprietorYes
Enumeration DateMarch 7, 2019
NPI 1104384262 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License Licensed in NC · FCL-001-107
Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

206 FRIENDLY RD, Burlington, NC 27217

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Custodial Care Facility (Adult Care Home)
206 FRIENDLY RD
BURLINGTON, NC 27217
Custodial Care Facility (Adult Care Home)
206 FRIENDLY RD
BURLINGTON, NC 27217

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tavarius Moore's NPI number?

The NPI number for Tavarius Moore is 1104384262. It was assigned to this individual provider in the NPPES registry on March 7, 2019.

Where is Tavarius Moore located?

Tavarius Moore practices at 206 Friendly Rd, Burlington, NC 27217. The listed phone number is (804) 624-3515.

What is Tavarius Moore's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Tavarius Moore was last updated on March 7, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.