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General NPI Number Information
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NPI Number | 1376350363
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Entity Type | Organization
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Legal Business Name | LAZER HOLDINGS LLC
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 919 FREEDOM BLVD
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City | WATSONVILLE
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State | CA
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Zip | 95076-3804
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Country | US
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Telephone | 831-722-3581
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Fax |
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Provider Business Mailing Address
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Address Line | 919 FREEDOM BLVD
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City | WATSONVILLE
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State | CA
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Zip | 95076-3804
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Country | US
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Telephone | 831-722-3581
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | ROBERT BRANDI
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Credential |
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Telephone | 408-320-9897
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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