HAVEN OF FLAGSTAFF, LLC (NPI# 1588901839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588901839 |
| Entity Type | Organization |
| Organization Name | HAVEN OF FLAGSTAFF, LLC |
| Practice Address |
800 W University Ave Flagstaff AZ 86001-7103 |
| Practice Telephone | 9287796931 |
| Practice Fax Number | 8928779218 |
| Mailing Telephone | 9287796931 |
| Mailing Fax Number | 8928779218 |
| Enumeration Date | 2013-01-07 |
| Last Update Date | 2020-01-23 |
| Authorized Official Name | BRETT P ROBERTSON (PRESIDENT) |
| Authorized Official Telephone | 8012965100 |
| Is Organization Subpart | Y |
| Parent Organization Name | HAVEN HEALTH GROUP ARIZONA, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | NCI-2662 | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 813243 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HAVEN OF FLAGSTAFF, LLC | 800 W University Ave, Flagstaff, AZ 86001-7103 |
| Street Address |
800 W UNIVERSITY AVE |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-7103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447256078 | Infinia At Flagstaff | Skilled Nursing Facility | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2005-06-28 |
| 1871130492 | Emily Terpay | Physical Therapist | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2019-12-02 |
| 1346761319 | Susan Jane Clow | Occupational Therapist | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2017-06-29 |
| 1124578695 | Shannon Estes | Physical Therapist | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2016-10-09 |
| 1366812869 | Sydney Petersen | Occupational Therapist | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2015-09-28 |
| 1255734372 | Whitney Warkentin | Speech-Language Pathologist | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2014-10-03 |
| 1215347265 | Cynthia Jalet | Physical Therapist | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2014-04-29 |
| 1982981767 | April Jannine Ater | Occupational Therapist | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2011-11-08 |
| 1992944151 | Ponderosa Pines Care and Rehab, Inc | Skilled Nursing Facility | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2009-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1205193901 | Althea Rehabilitation | Skilled Nursing Facility | 3397 S Carol Dr, Flagstaff, AZ 86001-9010 | 2012-04-18 |
| 1447256078 | Infinia At Flagstaff | Skilled Nursing Facility | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2005-06-28 |
| 1407482920 | Flagstaff Transitional Care, LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001-3269 | 2020-03-16 |
| 1992944151 | Ponderosa Pines Care and Rehab, Inc | Skilled Nursing Facility | 800 W University Ave, Flagstaff, AZ 86001-7103 | 2009-02-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023630175 | P. Deanda Medical Pllc | Skilled Nursing Facility | 1950 W Paseo Monserrat, Tucson, AZ 85704-1329 | 2020-05-12 |
| 1477187995 | Welbrook Yuma Opco LLC | Skilled Nursing Facility | 2271 S Ridgeview Dr, Yuma, AZ 85364-8872 | 2020-02-24 |
| 1487215067 | Ludden Healthcare, Inc. | Skilled Nursing Facility | 14660 W Parkwood Dr, Surprise, AZ 85374-4590 | 2019-06-25 |
| 1396208955 | Manuella D Khoshaba | Skilled Nursing Facility | 13821 W Crocus Dr, Surprise, AZ 85379-8340 | 2019-04-10 |
| 1518489244 | Moc Surprise, LLC | Skilled Nursing Facility | 14660 West Parkwood Drive, Surprise, AZ 85374 | 2017-07-14 |
| 1780106765 | Moc Tucson, LLC | Skilled Nursing Facility | 5151 East Pima Street, Tucson, AZ 85712 | 2017-07-12 |
| 1053833038 | Moc Chandler, LLC | Skilled Nursing Facility | 3033 South Arizona Ave., Chandler, AZ 85248 | 2017-07-12 |
| 1609307354 | Tucson Hacienda River, LLC | Skilled Nursing Facility | 2720 E River Road, Tucson, AZ 85718 | 2017-03-24 |
| 1891234126 | Center At Tucson, LLC | Skilled Nursing Facility | 5020 East Glen Street, Tucson, AZ 85712 | 2017-02-20 |
| 1770026361 | Lifestream Complete Senior Living, Inc. | Skilled Nursing Facility | 11521 W. Peoria Avenue, Youngtown, AZ 85363 | 2016-11-30 |
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| 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.