National Provider Identifier Database

MOSES BEHAVIORAL CARE
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.


Contact Information

MOSES BEHAVIORAL CARE
17622 W PORT ROYALE LN
SURPRISE, AZ85379
Phone: 480-286-3366
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Mental Illness 320800000X

* Indicates primary specialty

NPI Profile & details for MOSES BEHAVIORAL CARE

NPI Number 1255725248
Legal business name
LBN
MOSES BEHAVIORAL CARE
Authorized official ELIZABETH AGBOOLA - (ADMINISTRATOR)
Entity Organization
Organization subpart Yes
Enumeration date 03/27/2015
Last updated 07/10/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: BH4520
  • AZ Medicaid: 986532

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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