| NPI Details | |
|---|---|
| NPI | 1447657994 |
| Enumeration Date | 11/28/2014 |
| Last Updated | 09/21/2015 |
| Entity Type | Healthcare Provider |
| Active | Over 3 years ago |
| Authorized Information | |
|---|---|
| Name | BRETT BRETT |
| Position | CEO |
| Phone | (801) 296-5100 |
| Fax | |
| Practice Location | |
|---|---|
| 3401 LOCKWOOD DR LAKESIDE AZ, 85929-5613, US |
|
| Phone | (801) 296-5100 |
| Fax | |
| Business Location | |
|---|---|
| 3401 LOCKWOOD DR LAKESIDE AZ, 85929-5613, US |
|
| Phone | (801) 296-5100 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 314000000X |
| License State | |
| License Number | |
| Remove 1447657994 NPI Number | |
According to our database, Haven Of Lakeside Llc NPI is 1447657994, taxonomy code is 314000000X Haven Of Lakeside Llc physically located at 3401 Lockwood Dr, Lakeside AZ, 85929-5613. NPI Number 1033115704 has the healthcare provider type.
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1447657994 NPI number is provided on an as is basis without warranty of any kind. 1447657994 is maintained by the National Plan & Provider Enumeration System. The contents of Haven Of Lakeside Llc are for informational purposes only.
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