# HAVEN HEALTH AND WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871328211
- **Authorized official:** JEREMY LAZORKA (MANAGER)
- **Authorized official phone:** (570) 858-5328

## Contact information

- **Practice address:** 45 BELLEFONTE AVE, LOCK HAVEN, PA 17745
- **Practice address phone:** (570) 337-3440
- **Mailing address:** 45 BELLEFONTE AVE, SUITE \#2, LOCK HAVEN, PA 17745
- **Mailing address phone:** (570) 858-5328
- **Mailing address fax:** (570) 858-5355

## Taxonomy

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

## Other

- **Enumeration date:** 09/05/2024
- **Last updated:** 11/07/2024