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General NPI Number Information
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NPI Number | 1366314429
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Entity Type | Organization
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Legal Business Name | HAVENWOOD II
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 5500 W BAGLEY PARK RD
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City | WEST JORDAN
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State | UT
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Zip | 84081-5697
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Country | US
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Telephone | 435-586-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 2261 MARKET ST STE 5382
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-1612
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATHAN HOFELING
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Credential |
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Telephone | 435-586-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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