Organization
LA CASA SERENA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC LEE HAMBLIN (OWNER)
(928) 333-0151
Entity
Organization
Contact information
Practice address
324 EAST 1ST STREET, EAGAR, AZ 85925-0609
(928) 333-0151
(928) 333-0154
Mailing address
324 E 1ST STREET, EAGAR, AZ 85925-0609
(928) 333-0151
(928) 333-0154
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
AL6954
AZ
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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