HAVEN OF HOPE, INC. (NPI# 1134617798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134617798 |
| Entity Type | Organization |
| Organization Name | HAVEN OF HOPE, INC. |
| Other Organization Name | HAVEN OF HOPE, INC. - HALCYON |
| Practice Address |
107 Pauline Dr Watsonville CA 95076 |
| Mailing Address |
Po Box 610 Aptos CA 95001-0610 |
| Practice Telephone | 8313452238 |
| Practice Fax Number | 8314266348 |
| Mailing Telephone | 8313452238 |
| Mailing Fax Number | 8314266348 |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2018-05-15 |
| Authorized Official Name | MISS DAVINA POLANCO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8314253010 |
| Authorized Official Credential | MS, CTRS |
| Is Organization Subpart | Y |
| Parent Organization Name | HAVEN OF HOPE, INC. - HALCYON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 445200555 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Haven of Hope, Inc. - Halcyon | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619466489 | Haven of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 107 Pauline Dr, Watsonville, CA 95076-1063 | 2018-05-07 |
| 1912495441 | Haven of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2769 Valencia Rd, Aptos, CA 95003 | 2018-04-30 |
| Street Address |
107 PAULINE DR |
| City | WATSONVILLE |
| State | CA |
| Zip Code | 95076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293728 | Brianda Chavez | Counselor | 107 Pauline Dr, Watsonville, CA 95076-1063 | 2020-10-21 |
| 1619466489 | Haven of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 107 Pauline Dr, Watsonville, CA 95076-1063 | 2018-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757515 | Vicky E Gonzalez | Case Manager/Care Coordinator | 2714 Freedom Blvrd, Watsonville, CA 95076 | 2019-02-28 |
| 1861987059 | Encompass Community Services | Community/Behavioral Health | 2714 Freedom Blvd., Freedom, CA 95076 | 2018-06-29 |
| 1346743911 | Kathleen Long | Physician Assistant | 2468, 75 Nielson St, Watsonville, CA 95076 | 2018-03-09 |
| 1811403603 | Hieu Thi Thanh Nguyen Boulom | Pharmacist | 2810 Freedom Blvd, Watsonview, CA 95076 | 2017-12-16 |
| 1649798398 | Jonathon Rank | Counselor | 335 East Lake Ave, Watsonville, CA 95076 | 2017-09-01 |
| 1841653318 | Cristina Guzman | Registered Nurse | 195 Aviation Way, Ste 200, Watsonville, CA 95076 | 2016-04-01 |
| 1013388974 | Salud Para La Gente | Clinic/Center | 195 Aviation Way, Suite 200, Watsonville, CA 95076 | 2015-10-16 |
| 1386025757 | Yaseer Yousuf Parupia | Podiatrist | 47 Penny Lane, Suite 1, Watsonville, CA 95076 | 2015-06-11 |
| 1093100935 | Diana Perezchica | Counselor | 20716 Freedom Blv, Watsonville, CA 95076 | 2015-03-30 |
| 1083006597 | Raffaella Bianchi-allen | Marriage & Family Therapist | 113 E Lake Ave, Watsonville, CA 95076 | 2015-02-21 |
| Find all providers in zip 95076 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619466489 | Haven of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 107 Pauline Dr, Watsonville, CA 95076-1063 | 2018-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820499 | Catholic Charities of The Diocese of Oakland | Residential Treatment Facility, Emotionally Disturbed Children | 3700 Dorisa Ave, Oakland, CA 94605-4941 | 2020-10-27 |
| 1922607944 | Inspire A Youth, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7556 Avenida Baja, Riverside, CA 92509-3449 | 2020-10-21 |
| 1235736554 | Yvonne Dionne Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1223 E Helmick St, Carson, CA 90746-3163 | 2020-10-09 |
| 1740897784 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 602 Woodlark Dr, Suisun City, CA 94585-2244 | 2020-09-24 |
| 1548877657 | T & T House of Champions | Residential Treatment Facility, Emotionally Disturbed Children | 2115 High St, Oakland, CA 94601-4335 | 2020-09-23 |
| 1902412182 | Paradise Adolescent Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 136 Valdivia Cir, San Ramon, CA 94583-2228 | 2020-09-22 |
| 1073128492 | Samuel Campbell Jr. | Residential Treatment Facility, Emotionally Disturbed Children | 4200 Crescent Rock Ln, Bakersfield, CA 93311-2860 | 2020-09-11 |
| 1336753433 | Aaron's Boys Home | Residential Treatment Facility, Emotionally Disturbed Children | 5805 Capistrano Ave Ste E, Atascadero, CA 93422-7218 | 2020-09-04 |
| 1699389452 | Millie's Youth Services, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2512 Havenscourt Blvd, Oakland, CA 94605-1935 | 2020-08-31 |
| 1538779871 | Hidden Treasures Foundation, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1240 W 13th Ave, Escondido, CA 92025-5560 | 2020-08-02 |
| Find all providers with the same taxonomy | ||||
| City | WATSONVILLE |
| Zip Code | 95076 |
Please comment or provide details below to improve the information on HAVEN OF HOPE, INC..
| 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.