Provider Demographics
NPI:1093839920
Name:HEALING HAVENS, PLLC
Entity Type:Organization
Organization Name:HEALING HAVENS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-841-7576
Mailing Address - Street 1:5225 N 19TH AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-2903
Mailing Address - Country:US
Mailing Address - Phone:602-841-7576
Mailing Address - Fax:
Practice Address - Street 1:5225 N 19TH AVE
Practice Address - Street 2:SUITE E
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2903
Practice Address - Country:US
Practice Address - Phone:602-841-7576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-17
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8052111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHA857770Medicare ID - Type Unspecified
NJU61056Medicare UPIN