Organization
MOAHK BEHAVIORAL HOME LLC
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
HAJA SANKOH (CEO)
(623) 241-1982
Entity
Organization
Contact information
Practice address
16645 WEST CENTRAL STREET, SURPRISE, AZ 85388
(623) 241-1982
(623) 777-0810
Mailing address
16645 WEST CENTRAL STREET, SURPRISE, AZ 85388
(623) 241-1982
(623) 777-0810
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82182981
NON
AZ
01
—
NON
NON
—
Enumeration date
09/21/2018
Last updated
09/21/2018
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