Organization
HAVEN OF DOUGLAS, LLC
Active
Parent organization
HAVEN HEALTH GROUP ARIZONA, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAVEN HEALTH GROUP ARIZONA, LLC
Authorized official
BRETT P ROBERTSON (PRESIDENT)
(480) 935-4300
Entity
Organization
Contact information
Practice address
1400 N SAN ANTONIO AVE, DOUGLAS, AZ 85607-2434
(520) 364-7937
(520) 805-9146
Mailing address
1400 N SAN ANTONIO AVE, DOUGLAS, AZ 85607-2434
(520) 364-7937
(520) 805-9146
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-2708
AZ
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
813298
—
AZ
Enumeration date
01/07/2013
Last updated
05/22/2025
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