Organization
SHARED SPACES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN LACY (DO)
(602) 319-8130
Entity
Organization
Contact information
Practice address
42105 W CHEYENNE DR, MARICOPA, AZ 85138-3356
(602) 319-8130
(520) 568-2709
Mailing address
42105 W CHEYENNE DR, MARICOPA, AZ 85138-3356
(602) 319-8130
(520) 568-2709
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP2400X
Prison Health Clinic/Center
—
—
310400000X
Assisted Living Facility
—
—
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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