Havasu Regional Medical Center, LLC

Primary specialty

Rehabilitation Hospital UnitTaxonomy code 273Y00000X

License

SH-2409 Issued in AZ

Legal business name

HAVASU REGIONAL MEDICAL CENTER, LLC

Doing business as

Havasu Regional Medical Center Rehabilitation Program

Practice address

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Phone

(928) 855-8185

Fax

(928) 505-5768

NPI assigned

Aug 15, 2006

Organization subpart

Yes

Parent organization

HAVASU REGIONAL MEDICAL CENTER, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathy J. Teague

Title

Secretary

Phone

(615) 372-8500

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Havasu Regional Medical Center Rehabilitation Program Doing business as

Part of

Havasu Regional Medical Center LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564099200000",
    "number": "1740293950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 POWELL CT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275079",
            "telephone_number": "615-372-8500",
            "fax_number": "615-372-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-855-8185",
            "fax_number": "928-505-5768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVASU REGIONAL MEDICAL CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAVASU REGIONAL MEDICAL CENTER, LLC",
        "enumeration_date": "2006-08-15",
        "last_updated": "2019-07-26",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-372-8500"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "AZ",
            "license": "SH-2409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP33227",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XHSP43227",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "445131",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Havasu Regional Medical Center Rehabilitation Program",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Havasu Regional Medical Center Rehabilitation Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Havasu Regional Medical Center LLC
• Havasu Regional Medical Center LLC
• Havasu Regional Medical Center LLC
• Havasu Regional Medical Center LLC
• Havasu Regional Medical Center LLC
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• Rehabilitation Hospital Unit in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Rehabilitation Hospital Unit in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.