MOSES BEHAVIORAL CARE (NPI# 1447658943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447658943 |
| Entity Type | Organization |
| Organization Name | MOSES BEHAVIORAL CARE |
| Practice Address |
17622 W Port Royale Ln Surprise AZ 85388-7792 |
| Practice Telephone | 4802863366 |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-22 |
| Authorized Official Name | CLEMENT AGBOOLA (OWNER) |
| Authorized Official Telephone | 4802863366 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | BH4520 | AZ | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 918102 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255725248 | Moses Behavioral Care | Community Based Residential Treatment Facility, Mental Illness | 17622 W Port Royale Ln, Surprise, AZ 85379 | 2015-03-27 |
| Street Address |
17622 W PORT ROYALE LN |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85388-7792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255725248 | Moses Behavioral Care | Community Based Residential Treatment Facility, Mental Illness | 17622 W Port Royale Ln, Surprise, AZ 85379 | 2015-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508410887 | Kids Dentists of Surprise and Orthodontics, LLP | Dentist | 15180 N. Cotton Lane, Suite 104, Surprise, AZ 85388 | 2019-07-25 |
| 1588148803 | Moahk Behavioral Home LLC | Assisted Living Facility | 16645 West Central Street, Surprise, AZ 85388 | 2018-09-21 |
| 1881118867 | Haja Sankoh | Behavior Technician | 16645 West Central St, Surprise, AZ 85388 | 2017-08-01 |
| 1235516675 | Benjamin J Hegenbarth | Family Medicine | 14981 Nth 174 Dr., Surprise, AZ 85388 | 2015-05-06 |
| 1447644521 | Urgent Care Centers of Arizona, LLC | Clinic/Center | 16840 W. Waddell Road, Suite 110, Surprise, AZ 85388 | 2015-03-26 |
| 1548512239 | We Care Medical Supply Plus | Durable Medical Equipment & Medical Supplies | 17317 W. Banff Lane, Surprise, AZ 85388 | 2012-10-05 |
| 1376871095 | Rebecca Kimberly Adamoli | Nurse's Aide | 17999 N. Surprise Farms Loop South, Surprise, AZ 85388 | 2009-11-19 |
| 1417281395 | Tracy Dunbar | Respite Care | 18245 West Port Royale Ln., Surprise, AZ 85388 | 2009-09-25 |
| 1467696617 | Eileen Georgina Soltis | Registered Nurse | 17359 W. Surprise Farms Loop N, Surprise, AZ 85388 | 2009-04-30 |
| 1538306360 | Wholistic Integrative Caring Network LLC | Nurse Practitioner | 16278 N. 164th Lane, Surprise, AZ 85388 | 2009-01-15 |
| Find all providers in zip 85388 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134529282 | Marhaba Home Care LLC | Residential Treatment Facility, Physical Disabilities | 15244 W Watson Ln, Surprise, AZ 85379-7040 | 2014-08-26 |
| 1154634392 | Adora Property Management, LLC | Residential Treatment Facility, Physical Disabilities | 12425 W Bell Rd, Ste 200, Surprise, AZ 85374-9002 | 2010-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427656651 | Serenity Home Care LLC | Residential Treatment Facility, Physical Disabilities | 6858 S 19th St, Phoenix, AZ 85042-5770 | 2020-10-10 |
| 1073147195 | Armada Group-az, LLC | Residential Treatment Facility, Physical Disabilities | 1612 E. Knoll Circle, Mesa, AZ 85203 | 2020-02-27 |
| 1497385892 | Serenity Home Care LLC | Residential Treatment Facility, Physical Disabilities | 4451 W St Anne Ave, Laveen, AZ 85339-6232 | 2020-01-24 |
| 1023658127 | Carefree Manor Assisted Living LLC | Residential Treatment Facility, Physical Disabilities | 7886 E Breathless Dr, Carefree, AZ 85377 | 2020-01-07 |
| 1497234710 | Sampaguita D. Maglalang | Residential Treatment Facility, Physical Disabilities | My Home Care Adult Assisted Living Facility, LLC., 2607 West Curry Street, Chandler, AZ 85224-1040 | 2018-08-08 |
| 1326533407 | Neuro Rehabcare Scottsdale - Az LLC | Residential Treatment Facility, Physical Disabilities | 7480 E Camino Santo, Scottsdale, AZ 85260-3905 | 2018-06-29 |
| 1356853915 | Pastalino Manor 4 | Residential Treatment Facility, Physical Disabilities | 1421 E Maldonado Dr, Phoenix, AZ 85042-5602 | 2017-11-03 |
| 1770009219 | Neuro Rehabcare of The Valley - Az LLC | Residential Treatment Facility, Physical Disabilities | 8307 W Misty Willow Ln, Peoria, AZ 85383-1511 | 2017-08-16 |
| 1184150484 | Ndg Adult Care Home LLC | Residential Treatment Facility, Physical Disabilities | 1106 W 9th St, Tempe, AZ 85281-5304 | 2017-05-04 |
| 1194198697 | Amanda Ellis | Residential Treatment Facility, Physical Disabilities | 381 East Brook Street, San Tan Valley, AZ 85140 | 2015-11-05 |
| 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.