Organization
HAVEN OF LAKESIDE, LLC
Active
Parent organization
HAVEN HEALTH GROUP LLC
Other names
Haven Health Lakeside
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAVEN HEALTH GROUP LLC
Authorized official
BRETT ROBERTSON (CEO)
(480) 935-4300
Entity
Organization
Contact information
Practice address
3401 LOCKWOOD DR, LAKESIDE, AZ 85929-5613
(801) 296-5100
Mailing address
3401 LOCKWOOD DR, LAKESIDE, AZ 85929-5613
(801) 296-5100
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048299
—
AZ
Enumeration date
11/28/2014
Last updated
01/23/2026
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