HAVEN RECOVERY AZ LLC (NPI# 1396115234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396115234 |
| Entity Type | Organization |
| Organization Name | HAVEN RECOVERY AZ LLC |
| Practice Address |
9524 W Camelback Rd Ste C-130, #293 Glendale AZ 85305-3104 |
| Practice Telephone | 4058342993 |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2015-10-05 |
| Authorized Official Name | ERICH BRUESCHKE (MEMBER) |
| Authorized Official Telephone | 4058342993 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Street Address |
9524 W CAMELBACK RD STE C-130, #293 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85305-3104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467440818 | James Polkabla | Optometrist | 9524 W Camelback Rd, Glendale, AZ 85305-3104 | 2005-10-10 |
| 1093232514 | O'lua Therapy LLC | Occupational Therapy Assistant | 9524 W Camelback Rd, Ste. C-130 Pmb 232, Glendale, AZ 85305 | 2017-08-25 |
| 1336211531 | Nationwide Vision Center, LLC | Technician/Technologist | 9524 W Camelback Rd, Suite 150, Glendale, AZ 85305-3104 | 2006-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295368025 | Adam Stanley | Specialist/Technologist | 8769 West Northview Avenue, Glendale, AZ 85305 | 2020-02-20 |
| 1194216200 | Brandon Dawson | Dentist | 9455 W Glendale Ave, Glendale, AZ 85305 | 2018-05-24 |
| 1073030532 | Akdhc Surgery Center, LLC | Internal Medicine | 6622 N 91st Avenue, Suite 100, Glendale, AZ 85305 | 2017-08-25 |
| 1447772835 | Trekfit LLC | Dietitian, Registered | 9033 West State Avenue, Glendale, AZ 85305 | 2017-07-07 |
| 1194255885 | Akdhc,llc | Internal Medicine | 6622 N 91st Ave, Suite 200, Glendale, AZ 85305 | 2017-06-14 |
| 1124334933 | Marlana Angela Morrow | Pharmacist | 8990 W. Glendale Ave., Glendale, AZ 85305 | 2010-08-31 |
| 1750444261 | Norma Euyenia Quintero | Technician | 8950 W Sierra Vista, Glendale, AZ 85305 | 2006-12-18 |
| 1427325273 | Modern Dental Professionals-arizona PC | Dentist | 9230 W Northern Ave, 106, Glendale, AZ 85305-1100 | 2011-11-22 |
| 1134142409 | German Dobson Cvs LLC | Durable Medical Equipment & Medical Supplies | 9350 W Northern Ave, Glendale, AZ 85305-1103 | 2006-07-26 |
| 1326453002 | Kaiser Sultani | Optometrist | 9350 W Northern Ave, Glendale, AZ 85305-1103 | 2014-06-21 |
| Find all providers in zip 85305 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1942570130 | Tyd Executive Medical Clinic | Clinic/Center | 411 N Central Ave Ste 305, Glendale, CA 91203-2020 | 2012-01-05 |
| 1760624449 | Queens Neurorehabilitation, PC | Clinic/Center | 8727 Myrtle Ave, Glendale, NY 11385-7847 | 2009-03-27 |
| 1154562379 | Serenity Sleep Laboratories Inc | Clinic/Center | 1141 N Brand Blvd Ste 201, Suite 201, Glendale, CA 91202-3647 | 2009-03-18 |
| 1245442433 | Gastroenterology Associates of Southern California | Clinic/Center | 222w. Eulalia St., Suite 301, Glendale, CA 91204 | 2007-05-03 |
| 1073666269 | Dimitrios P Bousounis Md | Clinic/Center | 200 W Silver Spring Dr Ste 255, Glendale, WI 53217-5058 | 2007-01-19 |
| 1588270730 | Pediatric Sedation of Arizona | Clinic/Center | 20100 N 51st Ave Ste B220, Glendale, AZ 85308-5145 | 2020-09-22 |
| 1184237877 | Sudeep Punia Md PC | Clinic/Center | 7330 N 99th Ave Ste 205, Glendale, AZ 85307-3018 | 2020-08-24 |
| 1699289660 | Alexander G Gevorgyan Md Inc | Clinic/Center | 1332 S Glendale Ave, Glendale, CA 91205-3349 | 2017-11-28 |
| 1396266870 | Teni Minaeian Chiropractic Inc | Clinic/Center | 1451 E Chevy Chase Dr Ste 201, Glendale, CA 91206-4056 | 2017-07-05 |
| Find all providers in GLENDALE | ||||
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| 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.