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LODGE AT SEDONA LLC NPI 1780084236


NPI Information

NPI: 1780084236
Provider Name: LODGE AT SEDONA, LLC

Doing Business As: SEDONA WELLNESS RETREAT

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 03D2139869

Address:
125 KALLOF PL
LODGE AT SEDONA
SEDONA, AZ
ZIP 86336
Phone: (928) 204-1942
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LODGE AT SEDONA, LLC is a health service clinic center in Sedona, AZ. LODGE AT SEDONA, LLC NPI is 1780084236. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Sedona Wellness Retreat.

The provider's business location address is:

125 KALLOF PL
LODGE AT SEDONA
SEDONA, AZ
ZIP 86336-566
Phone: (928) 204-1942
Fax: (928) 204-2128

The provider's authorized official is Ryan Ferchoff .
The authorized official title is Director and has the following contact phone number (928) 613-2233.

The CLIA number assigned to this NPI record is 03D2139869 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/2/2014 and was last updated on 9/2/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1175F00000XNaturopathNo
2261QI0500XClinic/CenterInfusion TherapyNo
3324500000XSubstance Abuse Rehabilitation FacilityNo
4261QH0100XClinic/CenterHealth ServiceYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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