Organization
HAVENCOVE
Active
Other names
XaHris
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAELDIN MOHAMED PHARM.D (CHIEF OFFICER)
(402) 968-5295
Entity
Organization
Contact information
Practice address
16154 W DEVONSHIRE AVE, GOODYEAR, AZ 85395-6445
(213) 357-1299
Mailing address
15196 W WESTVIEW DR, GOODYEAR, AZ 85395-8290
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
10/31/2021
Last updated
11/02/2021
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