MOSES BEHAVIORAL CARE (NPI# 1255725248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255725248 |
Entity Type | Organization |
Organization Name | MOSES BEHAVIORAL CARE |
Practice Address |
17622 W Port Royale Ln Surprise AZ 85379 |
Mailing Address |
17622 W Port Royale Ln Surprise AZ 85388-7792 |
Practice Telephone | 4802863366 |
Enumeration Date | 2015-03-27 |
Last Update Date | 2015-03-27 |
Authorized Official Name | ELIZABETH AGBOOLA (ADMINISTRATOR) |
Authorized Official Telephone | 4802863366 |
Is Organization Subpart | Y |
Parent Organization Name | MOSES ASSISTED LIVING |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | BH4520 | AZ | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 986532 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447658943 | Moses Behavioral Care | Residential Treatment Facility, Physical Disabilities | 17622 W Port Royale Ln, Surprise, AZ 85388-7792 | 2014-12-15 |
Street Address |
17622 W PORT ROYALE LN |
City | SURPRISE |
State | AZ |
Zip Code | 85379 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447658943 | Moses Behavioral Care | Residential Treatment Facility, Physical Disabilities | 17622 W Port Royale Ln, Surprise, AZ 85388-7792 | 2014-12-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841818887 | Arizona Heartlands Home Care, LLC | Adult Companion | 14626 W. Wethersfield Rd, Surprise, AZ 85379 | 2020-07-07 |
1740832351 | Amanda Deangelis | Specialist/Technologist | 14064 W. Poinsettia Dr., Surprise, AZ 85379 | 2019-07-13 |
1720550767 | Anastasia Assisted Living Home LLC | Assisted Living Facility | 12805 N 145th Ave, Surprise, AZ 85379 | 2018-12-31 |
1306355821 | National Vision, Inc. | Technician/Technologist | Loop 303, Surprise, AZ 85379 | 2017-09-27 |
1306365770 | Christopher Albert Gard | Nurse Practitioner | 15643 W Cameron Dr, Surprise, AZ 85379 | 2017-09-16 |
1336667096 | Leon Quoc Lai | Pharmacist | 13723 Litchfield Rd, Surprise, AZ 85379 | 2017-09-01 |
1134664451 | Princess Valentin | Nurse Practitioner | 15400 W Waddell Road, Surprise, AZ 85379 | 2016-12-21 |
1871952408 | James Care Associates LLC | In Home Supportive Care | 12720 N. 149th Lane, Surprise, AZ 85379 | 2016-02-10 |
1669861688 | Todd Cleland | Physical Therapist | 15384 W. Dahlia Drive, Surprise, AZ 85379 | 2015-01-14 |
1326442187 | Sarpotdar Orthodontics, Pllc | Dentist | 13775 N. Litchfield Rd, Suite 108, Surprise, AZ 85379 | 2014-10-22 |
Find all providers in zip 85379 |
Taxonomy Code | 320800000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment Facility, Mental Illness |
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538788575 | Sweetwater Behavioral Health Services, LLC | Community Based Residential Treatment Facility, Mental Illness | 15778 W Caribbean Ln, Surprise, AZ 85379-6238 | 2020-04-09 |
1245860683 | Jmj Enterpise LLC | Community Based Residential Treatment Facility, Mental Illness | 14547 W Acapulco Ln, Surprise, AZ 85379-8548 | 2020-01-24 |
1952564544 | The Acapulco House | Community Based Residential Treatment Facility, Mental Illness | 14579 W Acapulco Ln, Surprise, AZ 85379-8548 | 2008-07-03 |
1851554448 | The Caribbean House | Community Based Residential Treatment Facility, Mental Illness | 14567 W Caribbean Ln, Surprise, AZ 85379-8546 | 2008-07-03 |
1083876825 | 145th Lane | Community Based Residential Treatment Facility, Mental Illness | 15266 N 145th Ln, Surprise, AZ 85379-8519 | 2008-07-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811598253 | Pinnacle Behavioral Health LLC | Community Based Residential Treatment Facility, Mental Illness | 45369 W Horse Mesa Rd, Maricopa, AZ 85139-9128 | 2020-11-03 |
1649878687 | Ayobami Noheem Agoro | Community Based Residential Treatment Facility, Mental Illness | 12362 W Joblanca Rd, Avondale, AZ 85323-3130 | 2020-10-13 |
1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
1144835968 | Jfox II LLC | Community Based Residential Treatment Facility, Mental Illness | 5327 E Enrose Cir, Mesa, AZ 85205-5489 | 2020-09-09 |
1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
1952913998 | Vema Corporation | Community Based Residential Treatment Facility, Mental Illness | 12701 N 79th Dr, Peoria, AZ 85381-9049 | 2020-08-20 |
1720698509 | Lyddia Getaweru | Community Based Residential Treatment Facility, Mental Illness | 2767 W Peggy Dr, Queen Creek, AZ 85142-6686 | 2020-08-05 |
1689284531 | Brain Solutions Pllc | Community Based Residential Treatment Facility, Mental Illness | 4555 S Maverick Ct, Gilbert, AZ 85297-9532 | 2020-08-05 |
1548879950 | C&j Care Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4418 W Darrel Rd, Laveen, AZ 85339-6222 | 2020-07-31 |
1295353019 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 2840 S Chaparral Blvd, Gilbert, AZ 85295-7675 | 2020-07-08 |
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.