MOAHK BEHAVIORAL HOME LLC (NPI# 1588148803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588148803 |
| Entity Type | Organization |
| Organization Name | MOAHK BEHAVIORAL HOME LLC |
| Practice Address |
16645 West Central Street Surprise AZ 85388 |
| Practice Telephone | 6232411982 |
| Practice Fax Number | 6237770810 |
| Mailing Telephone | 6232411982 |
| Mailing Fax Number | 6237770810 |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2018-09-21 |
| Authorized Official Name | HAJA SANKOH (CEO) |
| Authorized Official Telephone | 6232411982 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | NON | 82182981 | 01 |
| NON | NON | 01 |
| Other Name | Type Code |
|---|---|
| none | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16645 West Central Street, Surprise, AZ 85388 | 6232411982 | 6237770810 |
| Street Address |
16645 WEST CENTRAL STREET |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85388 |
| 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 |
| 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 |
| 1285856252 | Joseph Anthony Dellamarggio | Psychologist | 17901 W. Lundberg Street, Surprise, AZ 85388 | 2007-05-02 |
| Find all providers in zip 85388 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730684754 | Good Care Network LLC | Assisted Living Facility | 13250 W Port Royale Ln, Surprise, AZ 85379-6520 | 2018-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912511999 | Fanaka Enterprises LLC | Assisted Living Facility | 3925 E 1st St, Tucson, AZ 85711-1001 | 2020-09-07 |
| 1114536752 | The Heritage Behavioral Health Home LLC | Assisted Living Facility | 3927 W Rovey Ave, Phoenix, AZ 85019-1633 | 2020-07-29 |
| 1801420476 | Holy Trinity Behavioral,llc | Assisted Living Facility | 1630 W Nancy Ln, Phoenix, AZ 85041-5540 | 2020-02-23 |
| 1184258758 | Holy Trinity Behavioral,llc | Assisted Living Facility | 5308 W Vernon Ave, Phoenix, AZ 85035-1953 | 2020-02-23 |
| 1487287108 | Christine M Kemboi | Assisted Living Facility | 8435 W Hughes Dr, Tolleson, AZ 85353-3902 | 2020-02-20 |
| 1154967826 | Home of Empathy LLC | Assisted Living Facility | 8102 E 6th St, Tucson, AZ 85710-2416 | 2019-11-18 |
| 1083261945 | D&g Behavioral Health LLC | Assisted Living Facility | 3119 N 46th Dr, Phoenix, AZ 85031-3705 | 2019-08-24 |
| 1881249902 | A Tender Hand Assisted Living Home, LLC, Dba | Assisted Living Facility | 6216 S 36th St, Phoenix, AZ 85042-4904 | 2019-08-06 |
| 1265098339 | Affinity of Hope Care Home | Assisted Living Facility | 7518 S 15th Dr, Phoenix, AZ 85041-6935 | 2019-05-14 |
| 1912561176 | Hope Behavioral Health Residential Care | Assisted Living Facility | 17547 W Desert Bloom St, Goodyear, AZ 85338-4713 | 2019-04-23 |
| 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.