Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

The Lodge at 14th St

Organization Clinic/Center · NPI 1083698328

The Lodge at 14th St is a Clinic/Center in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2005.

Licensed in
AZ
In the registry since
2005
Specialties on file
3
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Practice location Address checks out

2941 N 14th St
Phoenix, AZ 85014-5604
Phone: (602) 279-1033
Fax: (602) 277-5604
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X
Clinic/Center Taxonomy 261Q00000X · Licence ALC 4746 (AZ)
Religious Nonmedical Health Care Institution Taxonomy 282J00000X · Licence ALC-4746 (AZ)

Record details

NPI number1083698328
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Garvey — General Partner · (602) 279-1033
Other names Crystal Lodge Investors
NPI enumeratedNovember 30, 2005
Last updated in NPPESOctober 23, 2024
Certification dateOctober 23, 2024
Mailing address2941 N. 14th St., Phoenix, AZ 85014-5604

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