HIGH DESERT HAVEN, INC (NPI# 1245385889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245385889 |
| Entity Type | Organization |
| Organization Name | HIGH DESERT HAVEN, INC |
| Practice Address |
13943 Trigger Ln Victorville CA 92392-6333 |
| 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 |
| 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 |
| Street Address |
13943 TRIGGER LN |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92392-6333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588006860 | Provident Place | Intermediate Care Facility, Mentally Retarded | 13943 Trigger Ln, Victorville, CA 92392-6333 | 2013-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215568688 | Kristin Parris | Behavior Technician | 15490 Civic Drive, Victorville, CA 92392 | 2020-02-03 |
| 1366001604 | Pine Ridge Treatment Centers, Inc. | Substance Abuse Rehabilitation Facility | 15367 Bonanza Rd, Ste A, Victorville, CA 92392 | 2019-06-11 |
| 1851871289 | Betty A. Murphy, Lmft, Inc | Marriage & Family Therapist | 15437 Anacapa Rd. Ste 26, Victorville, CA 92392 | 2018-08-15 |
| 1104313402 | Jorge L Soler Iglesias | Nurse Practitioner | 12459 Cricket St., Victorville, CA 92392 | 2018-04-23 |
| 1689192049 | Jamesina Johns | Nurse Practitioner | 12127 Mall Blvd #148, Victorville, CA 92392 | 2017-09-06 |
| 1285151886 | Jasmin Sanchez | Behavioral Analyst | 13201 Eclipse Ave, Victorville, CA 92392 | 2017-08-24 |
| 1174049829 | Virginia Marshall | Behavioral Analyst | 13901 Amargosa Rd., Victorville, CA 92392 | 2017-08-15 |
| 1346781465 | San Bernardino Conty | Counselor | 15480 Ramona Ave., Victoville, CA 92392 | 2017-03-09 |
| 1841741279 | Lorinda Morreale | Marriage & Family Therapist | 15428 Civic Dr. Ste 200, Act Family Counseling, Victorville, CA 92392 | 2016-10-20 |
| 1235582404 | Greater Hope Foundation | Community/Behavioral Health | 14344 Cajon Avenue, Suite 101, 103, Victorville, CA 92392 | 2016-07-22 |
| Find all providers in zip 92392 | ||||
| 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 |
|---|---|---|---|---|
| 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 | VICTORVILLE |
| Zip Code | 92392 |
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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.