Healthcare Provider Details

I. General information

NPI: 1851575625
Provider Name (Legal Business Name): LAJA TREATMENT CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10460 N 92ND ST SUITE 300
SCOTTSDALE AZ
85258-4549
US

IV. Provider business mailing address

10460 N 92ND ST SUITE 300
SCOTTSDALE AZ
85258-4549
US

V. Phone/Fax

Practice location:
  • Phone: 480-889-0180
  • Fax: 480-889-0186
Mailing address:
  • Phone: 480-889-0180
  • Fax: 480-889-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number24521
License Number StateAZ

VIII. Authorized Official

Name: DR. LISA JO STEARNS
Title or Position: OWNER/MANAGER
Credential: MD
Phone: 480-889-0180