Organization
HAVASU NURSING CENTER 2 INC
Active
Other names
Havasu Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFF SHIRRELL (VICE PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
3576 KEARSAGE DR, LAKE HAVASU CITY, AZ 86406-9115
(928) 453-1500
Mailing address
PO BOX 1210, SIKESTON, MO 63801-1210
(573) 471-1276
(573) 472-8504
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NC1-355
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041682
—
AZ
Enumeration date
07/07/2006
Last updated
08/31/2017
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