MEHRY LYN MOSES


Address: 1816 E Whitton Ave, Phoenix, AZ 85016-6416
Phone: 9283808641

MEHRY LYN MOSES (NPI# 1659987998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659987998
Entity Type Individual
Full Name MEHRY LYN MOSES
Credential CLS
Practice Address 1816 E Whitton Ave
Phoenix
AZ 85016-6416
Practice Telephone 9283808641
Mailing Telephone 9283808641
Enumeration Date 2020-09-22
Last Update Date 2020-09-22
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 310400000X Assisted Living Facility Nursing & Custodial Care Facilities
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities
N 347C00000X Private Vehicle Transportation Services
N 376J00000X Homemaker Nursing Service Related Providers
N 385HR2060X Respite Care
Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child
Respite Care Facility
N 253Z00000X In Home Supportive Care Agencies

Office Location

Street Address 1816 E WHITTON AVE
City PHOENIX
State AZ
Zip Code 85016-6416

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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Notes: [7/1/2003: new]

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1902131865 Master Care, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 28809 N 25th Gln, Phoenix, AZ 85085-3737 2009-10-11
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Competitor

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City PHOENIX
Zip Code 85016

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Dataset Information

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.

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