Organization
HAVASU REGIONAL MEDICAL CENTER, LLC
Active
Parent organization
HAVASU REGIONAL MEDICAL CENTER, LLC
Other names
Havasu Regional Medical Center Rehabilitation Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAVASU REGIONAL MEDICAL CENTER, LLC
Authorized official
KATHY J. TEAGUE (SECRETARY)
(615) 372-8500
Entity
Organization
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 855-8185
(928) 505-5768
Mailing address
103 POWELL CT, BRENTWOOD, TN 37027-5079
(615) 372-8500
(615) 372-8572
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
SH-2409
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
445131
—
AZ
05
—
XHSP33227
—
CA
05
—
XHSP43227
—
CA
Enumeration date
08/15/2006
Last updated
07/26/2019
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