Organization · NPI-2

Chosen Behavioral Home, LLC

Community Based Residential Treatment Facility, Mental Illness · Surprise, AZ

NPI number1962181024
StatusActive
Last updated in NPPESMay 25, 2024

Details

NPI
1962181024
Entity type
Organization (NPI-2)
Legal business name
Chosen Behavioral Home, LLC
Organization subpart
No
Enumeration date
Jul 17, 2023
Certification date
May 25, 2024
Last updated
May 25, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320800000X Community Based Residential Treatment Facility, Mental Illness––Yes
251S00000X Community/Behavioral Health––
324500000X Substance Abuse Rehabilitation Facility––
343900000X Non-emergency Medical Transport (VAN)––

Other names

  • Chosen Behavioral Home (Doing Business As)

Practice location

15639 N Verde St
Surprise, AZ 85378-4168

Phone 623-248-4100

Mailing address

15639 N Verde St
Surprise, AZ 85378-4168

Phone 480-241-6853

Authorized official

Sab Edwards
Owner
4802416853

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