Organization
HAVEN HEALTH PRESCOTT ALF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT P ROBERTSON (CEO)
(480) 935-4300
Entity
Organization
Contact information
Practice address
860 DOUGHERTY ST, PRESCOTT, AZ 86305-1841
(928) 778-9777
Mailing address
860 DOUGHERTY ST, PRESCOTT, AZ 86305-1841
(928) 778-9777
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831839547
—
AZ
Enumeration date
03/30/2022
Last updated
06/14/2024
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