Provider Demographics
NPI:1821458472
Name:HAUGEN & KECK INC
Entity Type:Organization
Organization Name:HAUGEN & KECK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:HAUGEN
Authorized Official - Last Name:KECK
Authorized Official - Suffix:
Authorized Official - Credentials:BASOCSCI/SPECED
Authorized Official - Phone:775-782-7019
Mailing Address - Street 1:1135 WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-5138
Mailing Address - Country:US
Mailing Address - Phone:775-781-6336
Mailing Address - Fax:775-782-7019
Practice Address - Street 1:1281 KIMMERLING RD
Practice Address - Street 2:SUITE A15, A14
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89460-7565
Practice Address - Country:US
Practice Address - Phone:775-309-3579
Practice Address - Fax:775-782-7019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20081296561385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care