MOSES BEHAVIORAL CARE; NPI #1255725248

Contact Information

MOSES BEHAVIORAL CARE

17622 W PORT ROYALE LN
SURPRISE, AZ 85379

Phone: 480-286-3366
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Community Based Residential Treatment Facility, Mental Illness	320800000X

Indicates primary specialty

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NPI Profile & details for MOSES BEHAVIORAL CARE

NPI # 1255725248

LBN Legal business name MOSES BEHAVIORAL CARE

Authorized official ELIZABETH AGBOOLA - (ADMINISTRATOR)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 03/27/2015

Last updated 07/10/2023 - About 3 years ago

Identifiers

AZ	License #	BH4520
AZ	Medicaid	986532

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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