OrganizationActive
Park Place Declarant
NPI 1487896114 · Hearing Aid Equipment · Lake Havasu City, AZ
Provider details
- NPI number
- 1487896114
- Entity type
- Organization
- Primary specialty
- Hearing Aid EquipmentSuppliers
- Organization subpart
- No
- Authorized official
- Suzanne Kelly, Owner(702) 807-7931
- License
- HAD5806 (AZ)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2105 Mcculloch Blvd N
#2
Lake Havasu City, AZ 86403-6772
Phone: (702) 807-7931
Fax: (702) 398-3757
Street-level locationGet directions
Mailing address
Po Box 224
Logandale, NV 89021-0224
Other names (DBA / former)
- Doing business as
- Fabulous Hearing
Registry dates
- Enumerated
- 2009-03-26
- Last updated
- 2009-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.