Healthcare Provider Details

I. General information

NPI: 1861629834
Provider Name (Legal Business Name): LAURA'S HEALING HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 06/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2952 E HADDAN CT
ELOY AZ
85231-2708
US

IV. Provider business mailing address

2952 E HADDAN CT
ELOY AZ
85231-2708
US

V. Phone/Fax

Practice location:
  • Phone: 520-450-9804
  • Fax: 520-723-4391
Mailing address:
  • Phone: 520-450-9804
  • Fax: 520-723-4391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number3824
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number3824
License Number StateAZ

VIII. Authorized Official

Name: LAURA CHRISTINE RAASTAD
Title or Position: OWNER/FOUNDER
Credential: OTR/L, CLT
Phone: 520-450-9804