PHC-LAKE HAVASU INC (NPI# 1245343482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245343482 |
| Entity Type | Organization |
| Organization Name | PHC-LAKE HAVASU INC |
| Other Organization Name | HAVASU REGIONAL MEDICAL CENTER HOME HEALTH |
| Practice Address |
1851 Mesquite Ave Ste. 206 Lake Havasu City AZ 86403-5677 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-4536 |
| Practice Telephone | 9286801209 |
| Practice Fax Number | 9286807914 |
| Mailing Telephone | 6159207000 |
| Mailing Fax Number | 6159208913 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-07-23 |
| Authorized Official Name | VICTOR E. GIOVANETTI (PRESIDENT) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | HHA0063 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 435992 | 05 |
| Other Name | Type Code |
|---|---|
| Havasu Regional Medical Center Home Health | Doing Business As Name - Organization |
| Street Address |
1851 MESQUITE AVE STE. 206 |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-5677 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770504870 | Mohave Medical Imaging Center | Physiological Laboratory | 1851 Mesquite Ave, Suite 112, Lake Havasu City, AZ 86403-5677 | 2006-07-22 |
| 1881041200 | Haylee Younis | Nurse Practitioner | 1851 Mesquite Ave, Suite 106, Lake Havasu City, AZ 86403-5677 | 2016-05-16 |
| 1891155974 | Hrmc, LLC | Dietitian, Registered | 1851 Mesquite Ave, Suite 202, Lake Havasu City, AZ 86403-5677 | 2016-03-02 |
| 1447630538 | Hrmc, LLC | Internal Medicine | 1851 Mesquite Ave, Suite 210, Lake Havasu City, AZ 86403-5677 | 2015-06-03 |
| 1811397748 | Akdhc, LLC | Internal Medicine | 1851 Mesquite Ave, Suite 216, Lake Havasu City, AZ 86403-5677 | 2014-08-28 |
| 1033435599 | Harrison Mark Mcdonald Do Pllc | Internal Medicine | 1851 Mesquite Ave, Suite 106, Lake Havasu City, AZ 86403-5677 | 2010-04-08 |
| 1104152768 | Cardiac and Vascular Associates LLC | Internal Medicine | 1851 Mesquite Ave, Suite 202, Lake Havasu City, AZ 86403-5677 | 2009-11-02 |
| 1255560884 | Khizer Salim Shaikh | Internal Medicine | 1851 Mesquite Ave, Suite 210, Lake Havasu City, AZ 86403-5677 | 2009-07-02 |
| 1437385192 | Arrow Perfusion Services LLC | Perfusionist | 1851 Mesquite Ave, Suite 202, Lake Havasu City, AZ 86403-5677 | 2009-06-08 |
| 1427283092 | Western Arizona Cardiovascular Surgery Pllc | Surgery | 1851 Mesquite Ave, Suite 202, Lake Havasu City, AZ 86403-5677 | 2009-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346856374 | Family Care Home Health & Hospice | Home Health | 1695 Mesquite Ave Ste 108, Lake Havasu City, AZ 86403-5684 | 2020-09-16 |
| 1124385430 | Flowers Assisted Living, Inc. | Home Health | 124 Lake Havasu Ave N, 102, Lake Havasu City, AZ 86403-5640 | 2012-04-12 |
| 1972803575 | Apismellis Homecare, LLC | Home Health | 500 Lake Havasu Ave N, Bahama Unit #d-102, Lake Havasu City, AZ 86403-3606 | 2010-10-28 |
| 1568792372 | Flower's Assisted Living, Inc | Home Health | 124 Lake Havasu Avenue N 102, Lake Havasu City, AZ 86403 | 2009-12-30 |
| 1811402332 | Foundation Home Health LLC | Home Health | 2250 Mcculloch Blvd N Ste K, Lake Havasu City, AZ 86403-6121 | 2017-12-06 |
| 1487190658 | Arizona In-home Partner-i, LLC | Home Health | 1830 Mesquite Ave Ste B, Lake Havasu City, AZ 86403-5885 | 2017-01-12 |
| 1578947842 | Mohave Healthcare, Inc. | Home Health | 500 Lake Havasu Ave N, Suite D-102, Lake Havasu City, AZ 86403-3606 | 2015-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881606 | Keystone Paramedical In-home Services, Inc. | Home Health | 1889 W Queen Creek Rd Apt 1112, Chandler, AZ 85248-3089 | 2020-11-05 |
| 1578162681 | Deshea Willis | Home Health | 21150 N Tatum Blvd Apt 3049, Phoenix, AZ 85050-7238 | 2020-10-20 |
| 1609474071 | Tender Loving Home Care LLC | Home Health | 4646 E Fort Lowell Rd Ste 106, Tucson, AZ 85712-1100 | 2020-10-16 |
| 1144828831 | Vital Homecare, Inc. | Home Health | 2375 E Camelback Rd Ste 632, Phoenix, AZ 85016-3424 | 2020-10-14 |
| 1124625645 | Bright Future Behavioral Homes LLC | Home Health | 4707 E Mcdowell Rd Apt 1197, Phoenix, AZ 85008-4534 | 2020-10-07 |
| 1578170643 | Arizona American Hospice | Home Health | 1325 S 123rd Dr, Avondale, AZ 85323-3140 | 2020-09-23 |
| 1083220891 | 360care | Home Health | 3719 S Atherton Blvd, Gilbert, AZ 85297-7431 | 2020-09-17 |
| 1255947156 | Royalty Healthcare LLC | Home Health | 5670 S Eucalyptus Pl, Chandler, AZ 85249-5224 | 2020-09-17 |
| 1699380048 | Robinson Group | Home Health | 1735 E Baker Dr, Tempe, AZ 85282-7206 | 2020-09-12 |
| 1144834318 | House of Shelter Incorporated | Home Health | 15757 W Moreland St, Goodyear, AZ 85338-4161 | 2020-09-03 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.