1346479128 NPI number — PARKHAVEN GROUP, INC.

Table of content: (NPI 1346479128)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346479128 NPI number — PARKHAVEN GROUP, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARKHAVEN GROUP, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346479128
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 HAMILTON CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANHATTAN
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59741-8160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-282-7488
Provider Business Mailing Address Fax Number:
406-284-7128

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 HAMILTON CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANHATTAN
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59741-8160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-282-7488
Provider Business Practice Location Address Fax Number:
406-284-7128
Provider Enumeration Date:
07/14/2009

Additional Information

Authorized Official

Authorized Official Last Name:
HAMILTON
Authorized Official First Name:
CRYSTAL
Authorized Official Middle Name:
D
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
406-282-7488

Provider Taxonomy Codes

  • Taxonomy code: 310400000X , with the licence number:  11860 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com