Individual provider · NPI-1

Raechelle Angelee Moffett, CEO, LVN

Clinic/Center, Adult Day Care · Killeen, TX

NPI number1710653407

StatusActive

Last updated in NPPESJun 7, 2023

Details

NPI: 1710653407
Entity type: Individual (NPI-1)
Name: Raechelle Angelee Moffett
Credential: CEO, LVN
Sex: Female
Sole proprietor: Yes
Enumeration date: Aug 21, 2021
Certification date: Jun 7, 2023
Last updated: Jun 7, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QA0600X	Clinic/Center, Adult Day Care	–	–	Yes
253Z00000X	In Home Supportive Care	–	–
310400000X	Assisted Living Facility	–	–
320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–
164X00000X	Licensed Vocational Nurse	327311	TX
251C00000X	Day Training, Developmentally Disabled Services	–	–
251J00000X	Nursing Care	–	–
332U00000X	Home Delivered Meals	–	–
372500000X	Chore Provider	–	–
372600000X	Adult Companion	–	–
374U00000X	Home Health Aide	–	–
320700000X	Residential Treatment Facility, Physical Disabilities	–	–
320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–

Practice location

5702 Greengate Dr Apt D
Killeen, TX 76543-9006

Phone 254-245-8058 · Fax 254-699-4189

Mailing address

5702 Greengate Dr Apt D
Killeen, TX 76543-9006

Phone 254-681-7975 · Fax 254-699-4189

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