MOSES ASSISTED LIVING LLC


Address: 827 E Chipman Rd, Phoenix, AZ 85040
Phone: 4802863366

MOSES ASSISTED LIVING LLC (NPI# 1184162588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184162588
Entity Type Organization
Organization Name MOSES ASSISTED LIVING LLC
Other Organization Name MOSES BEHAVIORAL CARE II
Practice Address 827 E Chipman Rd
Phoenix
AZ 85040
Practice Telephone 4802863366
Mailing Telephone 4802863366
Enumeration Date 2017-02-06
Last Update Date 2017-02-06
Authorized Official Name CLEMENT A AGBOOLA (CO OWNER)
Authorized Official Telephone 4802863366
Is Organization Subpart Y
Parent Organization Name MOSES ASSISTED LIVING LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness BH5042 AZ Residential Treatment Facilities

Other Provider/Organization Names

Other Name Type Code
MOSES BEHAVIORAL CARE II Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1598272825 Moses Assisted Living LLC Community Based Residential Treatment Facility, Mental Illness 829 E Chipman Rd, Phoenix, AZ 85040-8504 2018-01-09

Office Location

Street Address 827 E CHIPMAN RD
City PHOENIX
State AZ
Zip Code 85040

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Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

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Competitor

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City PHOENIX
Zip Code 85040

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Dataset Information

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.

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