HAPPY HAVEN AZ LLC (NPI# 1043846561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043846561 |
| Entity Type | Organization |
| Organization Name | HAPPY HAVEN AZ LLC |
| Practice Address |
1110 W Hadley St Phoenix AZ 85007-3610 |
| Practice Telephone | 8572007660 |
| Practice Fax Number | 6026751847 |
| Mailing Telephone | 8572007660 |
| Mailing Fax Number | 6026751847 |
| Enumeration Date | 2020-03-16 |
| Last Update Date | 2020-03-16 |
| Authorized Official Name | MR. GAEL KAROMBA (CEO) |
| Authorized Official Telephone | 8572007660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | BH6042 | 05 |
| Street Address |
1110 W HADLEY ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85007-3610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861017824 | Tembre Eliza Delong | Student in an Organized Health Care Education/Training Program | 230 South 12th Ave, Phoenix, AZ 85007 | 2020-06-15 |
| 1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
| 1922559624 | Community Bridges, Inc. | Community/Behavioral Health | 1125 W Jackson St, Phoenix, AZ 85007 | 2016-10-18 |
| 1912358045 | Isabel Victoria Rodriguez | Speech-Language Pathologist | 2302 North 15th Avenue, Phoenix, AZ 85007 | 2016-06-30 |
| 1730441825 | Sara Joyce Edmund | Nurse Practitioner | 1424 S 7th Avenue, Phoenix, AZ 85007 | 2012-06-13 |
| 1295781771 | Ilin Chuang | Pediatrics | 150 N. 18th Ave., Suite 150, Arizona Depart. of Health Services, Phoenix, AZ 85007 | 2006-05-26 |
| 1518924802 | Michael James Higbee | Physician Assistant | 1201 S. 7th Avenue, Suite 150, Phoenix, AZ 85007 | 2006-04-28 |
| 1942278676 | David Paul Brown | Emergency Medicine | 1201 S 7 Avenue, Phoenix, AZ 85007 | 2006-03-09 |
| 1265409759 | Carol D Watkins | Emergency Medicine | 1201 S 7th Avenue, Phoenix, AZ 85007 | 2006-03-02 |
| 1982695615 | Mary Pat Nesbit | Emergency Medicine | 1201 S 7th Ave, Phoenix, AZ 85007 | 2005-11-02 |
| Find all providers in zip 85007 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235736018 | Happy Valley Community Services LLC | Community Based Residential Treatment Facility, Mental Illness | 1106 E Cochise Dr, Phoenix, AZ 85020-1550 | 2020-10-05 |
| 1639782956 | Ascend Behavioral Health and Wellness,llc | Community Based Residential Treatment Facility, Mental Illness | 3308 W Desert Vista Trl, Phoenix, AZ 85083-5874 | 2020-08-26 |
| 1588281604 | Alliance Behavioral Care LLC | Community Based Residential Treatment Facility, Mental Illness | 1402 E Hoover Ave, Phoenix, AZ 85006-1737 | 2020-07-06 |
| 1174143846 | Alpine Villa LLC | Community Based Residential Treatment Facility, Mental Illness | 14414 N 29th St, Phoenix, AZ 85032-5004 | 2020-04-22 |
| 1346860657 | Semper Fidelis Behavioral Health & Counseling, LLC | Community Based Residential Treatment Facility, Mental Illness | 3606 E Baseline Rd Unit 288, Phoenix, AZ 85042-9617 | 2020-04-16 |
| 1548889793 | Shea Home LLC | Community Based Residential Treatment Facility, Mental Illness | 10435 N 40th St, Phoenix, AZ 85028-4043 | 2020-04-08 |
| 1699394858 | Acome Home LLC | Community Based Residential Treatment Facility, Mental Illness | 4509 E Acoma Dr, Phoenix, AZ 85032-4855 | 2020-04-08 |
| 1033748009 | Optimum Care of Arizona LLC | Community Based Residential Treatment Facility, Mental Illness | 717 E Harwell Rd, Phoenix, AZ 85042-6655 | 2020-04-02 |
| 1942835806 | Mercy Favor and Grace Social Services | Community Based Residential Treatment Facility, Mental Illness | 9431 W Sheridan St, Phoenix, AZ 85037-4435 | 2020-03-10 |
| 1891320271 | The Family House, LLC | Community Based Residential Treatment Facility, Mental Illness | 3017 W Pecan Rd, Phoenix, AZ 85041-4429 | 2020-03-06 |
| Find all providers in PHOENIX | ||||
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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.