Organization
MOHAVE HEALTH AND WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANESE DIAMOND (OWNER)
(480) 521-9859
Entity
Organization
Contact information
Practice address
1940 MESQUITE AVE STE P-1, LAKE HAVASU CITY, AZ 86403-6123
(602) 706-4405
Mailing address
1940 MESQUITE AVE STE P-1, LAKE HAVASU CITY, AZ 86403-6123
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/23/2023
Last updated
01/25/2024
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