HIGH DESERT HAVEN (NPI# 1245385863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245385863 |
| Entity Type | Organization |
| Organization Name | HIGH DESERT HAVEN |
| Practice Address |
15448 Mondamon Rd Apple Valley CA 92307-4557 |
| Mailing Address |
Pmb 201 20162 Hwy 18, Ste G Apple Valley CA 92307 |
| Practice Telephone | 7602409896 |
| Practice Fax Number | 7602409876 |
| Mailing Telephone | 7602409896 |
| Mailing Fax Number | 7602409876 |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. TRACEY ALLEN GRAHAM (FACILITY MANAGER) |
| Authorized Official Telephone | 7602409896 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | CA | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | HIGH DESERT HAVEN INC | 1940 Se Arborwood Ave, Bend, OR 97702 |
| Street Address |
15448 MONDAMON RD |
| City | APPLE VALLEY |
| State | CA |
| Zip Code | 92307-4557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508208877 | Provident Place | Intermediate Care Facility, Mentally Retarded | 15448 Mondamon Rd, Apple Valley, CA 92307-4557 | 2013-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679106025 | Rajender S. Thakran, M.d., Inc | Specialist | 16030 Kamana Rd, Apple Valley, CA 92307 | 2020-02-13 |
| 1477119980 | Harpreet Singh | Nurse Practitioner | 18300 Ca-18, Apple Valley, Ca 92307, Apple Valley, CA 92307 | 2019-05-10 |
| 1184120784 | Frantz Jean-louis | Nurse Practitioner | 16134 Muni Rd, Apple Valley, CA 92307 | 2018-04-03 |
| 1053862078 | Ashley M Morello | Registered Nurse | Universal Pain Management, 16179 Siskiyou, Apple Valley, CA 92307 | 2016-10-14 |
| 1891191680 | Ann Simonds | Marriage & Family Therapist | 20601 Us Highway 18 Ste 123, Apple Valley, CA 92307 | 2014-11-06 |
| 1396147419 | Aaa Family Medical Group | Family Medicine | 15995 Tuscola Rd Ste 202, Apple Valley, CA 92307 | 2014-09-19 |
| 1659780534 | Relena Tran | Pharmacist | 20251 Highway 18, Apple Valley, CA 92307 | 2014-08-05 |
| 1639508526 | Meagan Katherine Blades | Physician Assistant | 18300 Outer Hwy 18, Apple Valley, CA 92307 | 2013-11-01 |
| 1720341555 | Jonathan Robert Cox | Dermatology | 18523 Corwin Rd Ste G, Apple Valley, CA 92307 | 2012-06-18 |
| 1821364365 | Leary Sport and Spine Chiropractic Inc. | Chiropractor | 18564 Us Highway 18 Suite, 303, Apple Valley, CA 92307 | 2012-03-29 |
| Find all providers in zip 92307 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467507087 | High Desert Haven, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 20400 Ituma Rd, Apple Valley, CA 92308-4445 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538776323 | Calston Manor | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 44661 Calston Ave, Lancaster, CA 93535-3430 | 2020-09-25 |
| 1457966822 | Invincible Villas, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 27539 Glasser Ave, Canyon Country, CA 91351-2039 | 2020-09-12 |
| 1528671633 | Eliaa, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1229 Kelley Avenue, Corona, CA 92882-4207 | 2020-08-28 |
| 1902417090 | Kavere Services Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 531 N Mills Ave, Lodi, CA 95242-2220 | 2020-08-12 |
| 1568071488 | Jnp Residential | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1518 S Wadsworth Ave, Compton, CA 90220-3951 | 2020-07-27 |
| 1043833734 | E&s Jensen Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9629 Ridgerock Dr, Elk Grove, CA 95624-4461 | 2020-05-28 |
| 1124663588 | The Caring Bunch | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4355 Sepulveda Blvd Apt 125, Sherman Oaks, CA 91403-3911 | 2019-11-08 |
| 1821655507 | Creative Lifestyles Home Care Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1022 W Florence Ave, Los Angeles, CA 90044-2442 | 2019-05-28 |
| 1386160562 | Blueprint Development Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2501 Sycamore Ln, Palmdale, CA 93551-1518 | 2017-08-18 |
| 1427592963 | Carissa Group Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1048 Stowell Ranch Cir, Corona, CA 92881-4739 | 2016-12-16 |
| Find all providers with the same taxonomy | ||||
| City | APPLE VALLEY |
| Zip Code | 92307 |
Please comment or provide details below to improve the information on HIGH DESERT HAVEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.