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Organization

HAVEN RECOVERY AZ LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERICH BRUESCHKE (MEMBER)
(405) 834-2993
Entity
Organization

Contact information

Practice address
9524 W CAMELBACK RD, STE C-130, #293, GLENDALE, AZ 85305-3104
(405) 834-2993
Mailing address
9524 W CAMELBACK RD, STE C-130, #293, GLENDALE, AZ 85305-3104

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary

Other

Enumeration date
10/05/2015
Last updated
10/05/2015
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