MEDICARE: LAGO MANAGEMENT INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1316652944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAGO MANAGEMENT INC

Provider Business Mailing Address
First Line	:	1800 E YELLOWSTONE PL
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85249-2851
Country	:	US
Telephone Number	:	978-621-7697
Fax Number	:

Provider Business Practice Location Address
First Line	:	3377 S PRICE RD STE 107
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85248-3578
Country	:	US
Telephone Number	:	480-725-8477
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GREGORY CONTINO
Credential	:
Telephone Number	:	978-621-7697

Provider Enumeration Date	:	01/18/2023
Last Update Date	:	01/18/2023

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Directions to “LAGO MANAGEMENT INC ” Practice Location

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