# HAVENLIGHT PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Havenlight Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568042513
- **Authorized official:** DR. BENJAMIN REESER MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (623) 396-5623

## Contact information

- **Practice address:** 7160 E KIERLAND BLVD, STE 213, SCOTTSDALE, AZ 85254-2987
- **Practice address phone:** (623) 396-5623
- **Mailing address:** 809 W RIORDAN RD STE 100-132, FLAGSTAFF, AZ 86001-0842

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/13/2021
- **Last updated:** 04/26/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | Z257365 | — | AZ |