HEAVENLY HAVEN (NPI# 1861515009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861515009 |
| Entity Type | Organization |
| Organization Name | HEAVENLY HAVEN |
| Practice Address |
4824 E Brookstown Dr Baton Rouge LA 70805-3823 |
| Practice Telephone | 2253577206 |
| Practice Fax Number | 2253576424 |
| Mailing Telephone | 2253577206 |
| Mailing Fax Number | 2253576424 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2008-03-14 |
| Authorized Official Name | MRS. DOROTHY M NELSON (CEO) |
| Authorized Official Telephone | 2253575126 |
| 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 | 7259 | LA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1428744 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295284727 | Heavenly Haven | Clinic/Center | 4748 Clover St, Unit A, Houston, TX 77033-4047 | 2016-09-26 |
| 1871044925 | Heavenly Haven | Clinic/Center | 4748 Clover St, Unit A, Houston, TX 77033-4047 | 2016-10-24 |
| 1306005996 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-06-09 |
| 1659544377 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-04-03 |
| 1174794325 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-03-17 |
| 1487825741 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-03-14 |
| 1740489152 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-07-16 |
| 1093913485 | Heavenly Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-07-06 |
| 1659577922 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-06-25 |
| 1952424194 | Heavenly Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-04-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | HEAVENLY HAVEN LLC | 1823 N Center Ln, Po Box 11701, Spokane Valley, WA 99211 |
| Colorado Business Entities | Heavenly Haven LLC | 4527 Palmer Park Blvd, Colorado Springs, CO 80915 |
| Street Address |
4824 E BROOKSTOWN DR |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70805-3823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396702866 | Heavenly Haven, Inc. | Respite Care | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2006-04-28 |
| 1467760579 | Heavenly Haven Care Service | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2010-09-23 |
| 1306005996 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-06-09 |
| 1659544377 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-04-03 |
| 1174794325 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-03-17 |
| 1487825741 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-03-14 |
| 1740489152 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-07-16 |
| 1093913485 | Heavenly Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-07-06 |
| 1659577922 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-06-25 |
| 1952424194 | Heavenly Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306481445 | Upgrade Group Home LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3719 Katherine Ave, 3719 Katherine Ave, Baton Rouge, LA 70805 | 2019-11-13 |
| 1164991899 | Hip Hop Barbers, LLC | Specialist | 5709 Hollywood Crossover St, Baton Rouge, LA 70805 | 2018-11-26 |
| 1093234783 | Omar Feme Braggs I | Counselor | 3973 Choctaw Drive, Baton Rouge, LA 70805 | 2017-09-13 |
| 1558883116 | Jeffrey Williams | Counselor | 3456 Eaton Street, Baton Rouge, LA 70805 | 2017-07-14 |
| 1215466628 | Angel Danielle Morgan | Counselor | 3540 Ontario St., Baton Rouge, LA 70805 | 2017-06-08 |
| 1376904151 | Mama's Medical Transportation | Non-emergency Medical Transport (VAN) | 2727 North Ardenwood Dr., Baton Rouge, LA 70805 | 2016-03-08 |
| 1013389105 | Tiffany Thomas | Counselor | 8325 Kelwood Avenue, Baton Rouge, LA 70805 | 2015-10-28 |
| 1366823395 | Travia Linette Washington | Community Health Worker | 2959 Sherwood St, Baton Rouge, LA 70805 | 2015-06-16 |
| 1295000164 | Capital Area Human Services District | Substance Abuse Rehabilitation Facility | 2455 Wooddale Blvd., Baton Rouge, LA 70805 | 2012-03-12 |
| 1427332238 | Carl P Thibodeaux | Pharmacist | 5889 Airline Highway, Baton Rouge, LA 70805 | 2011-09-29 |
| Find all providers in zip 70805 | ||||
| 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 |
|---|---|---|---|---|
| 1609495324 | 180 Family Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9418 Brookline Ave Ste B, Baton Rouge, LA 70809-1428 | 2020-04-13 |
| 1992101927 | Ddms of Louisiana No 2, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4532 Inchbrook Dr, Baton Rouge, LA 70816-4910 | 2014-11-19 |
| 1073732954 | Cb's Place Group Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2736 Florida Blvd, Baton Rouge, LA 70802-2719 | 2007-04-25 |
| 1184841488 | Shekinah Glory Ministry of Baton Rouge | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3613 Government St, Baton Rouge, LA 70806-5721 | 2007-04-19 |
| 1710383740 | Ddms of Louisiana No 2, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 13231 Wenham Ave, Baton Rouge, LA 70815-6958 | 2014-11-19 |
| 1982000915 | Ddms of Louisiana No 2, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 11055 Mollylea Dr, Baton Rouge, LA 70815-5243 | 2014-11-19 |
| 1588961874 | Harmony Center, Incorporated | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2736 Florida Blvd, Baton Rouge, LA 70802-2719 | 2011-02-22 |
| 1043517337 | Harmony Center, Incorporated | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2736 Florida Blvd, Baton Rouge, LA 70802-2719 | 2011-02-22 |
| 1346547155 | Harmony Center, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2736 Florida Blvd, Baton Rouge, LA 70802-2719 | 2011-02-15 |
| 1063609204 | Shekinah Glory | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3613 Government St, Baton Rouge, LA 70806-5721 | 2007-10-02 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70805 |
Please comment or provide details below to improve the information on HEAVENLY 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.