Moses Behavioral Care

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

BH4520 Issued in AZ

Legal business name

MOSES BEHAVIORAL CARE

Practice address

17622 W Port Royale LN
Surprise, AZ 85388-7792

Phone

(480) 286-3366

NPI assigned

Dec 15, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steve Agboola

Title

Administrator

Phone

(480) 589-6692

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Moses Behavioral Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Moses Behavioral Care

  • Mental Illness Community Based Residential Treatment Facility
  • Surprise, AZ
  • NPI 1255725248
  NPD tax ID
• Trinity Integrated Healthcare

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1184162588
  NPD tax ID
• Trinity Integrated Healthcare

  • Mental Illness Community Based Residential Treatment Facility
  • Phoenix, AZ
  • NPI 1598272825
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1447658943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17622 W PORT ROYALE LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853887792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17622 W PORT ROYALE LN",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853887792",
            "telephone_number": "480-286-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSES BEHAVIORAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-15",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "AGBOOLA",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-589-6692"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "AZ",
            "license": "BH4520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "918102",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Morris, DO
• Tiffany Morris
• Tyler Morrison, PHARMD
• Katia Porshe Mosby, LMT
• Moses Behavioral Care
• Amin Mosharaf, PHARMD
• Valencia L Mosley, M.D.
• Samantha Cheyenne-Dahl Moss, LPC
• Steven B Moss, P.A.
• Tyler A Moss, D.O.

• Physical Disabilities Residential Treatment Facility in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Physical Disabilities Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.