Provider Demographics
NPI:1790160927
Name:HAAF NEURODEVELOPMENT, INC.
Entity Type:Organization
Organization Name:HAAF NEURODEVELOPMENT, INC.
Other - Org Name:HOPE AND A FUTURE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NEURODEVELOPMENTALIST
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-395-1979
Mailing Address - Street 1:PO BOX 4620
Mailing Address - Street 2:3702 BUNYAN CIRCLE
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-0013
Mailing Address - Country:US
Mailing Address - Phone:801-395-1979
Mailing Address - Fax:801-627-1831
Practice Address - Street 1:2485 GRANT AVE
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-2308
Practice Address - Country:US
Practice Address - Phone:801-395-1979
Practice Address - Fax:801-627-1831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty