# HAVEN OF LAKESIDE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HAVEN HEALTH GROUP LLC
- **Other names:** Haven Health Lakeside
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1447657994
- **Legal business name:** HAVEN HEALTH GROUP LLC
- **Authorized official:** BRETT ROBERTSON (CEO)
- **Authorized official phone:** (480) 935-4300

## Contact information

- **Practice address:** 3401 LOCKWOOD DR, LAKESIDE, AZ 85929-5613
- **Practice address phone:** (801) 296-5100
- **Mailing address:** 3401 LOCKWOOD DR, LAKESIDE, AZ 85929-5613
- **Mailing address phone:** (801) 296-5100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 11/28/2014
- **Last updated:** 01/23/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 048299 | — | AZ |