HIGH DESERT HAVEN, INC (NPI# 1467507087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467507087 |
| Entity Type | Organization |
| Organization Name | HIGH DESERT HAVEN, INC |
| Practice Address |
20400 Ituma Rd Apple Valley CA 92308-4445 |
| 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 |
|---|---|---|---|---|
| 1245385889 | High Desert Haven, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 13943 Trigger Ln, Victorville, CA 92392-6333 | 2007-01-24 |
| Street Address |
20400 ITUMA RD |
| City | APPLE VALLEY |
| State | CA |
| Zip Code | 92308-4445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558703827 | Provident Place | Intermediate Care Facility, Mentally Retarded | 20400 Ituma Rd, Apple Valley, CA 92308-4445 | 2013-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144831850 | Lisa K Frandsen | Behavioral Analyst | 19794 Poppy Rd, Apple Valley, CA 92308 | 2020-08-14 |
| 1518484195 | Jennifer Redwine | Behavioral Analyst | 1905 Business Center Drive South, Unit 100, San Bernardino, CA 92308 | 2017-08-24 |
| 1508397100 | West Care Transportation | Non-emergency Medical Transport (VAN) | 15480 Straight Arrow Rd #b, Apple Valley, CA 92308 | 2017-03-24 |
| 1811346497 | E Kim Dental Corp | Dentist | 21580 Bear Valley Rd., Ste B2-2, Apple Valley, CA 92308 | 2016-06-06 |
| 1134575376 | Seth Owuor | Pharmacist | 14426 Palmdale Road, Victorville, CA 92308 | 2016-05-06 |
| 1043608763 | Kamal Ebadpour | Adult Companion | 13224 Iroquois Road, Apple Valley, CA 92308 | 2015-01-05 |
| 1487099669 | Hateem Siddiqui | Internal Medicine | 19059 Bear Valley Rd # 3, Apple Valley, CA 92308 | 2013-05-01 |
| 1225305618 | Edward N. Sianipar | Nurse Practitioner | 19059 Bear Valley Rd., #1, Apple Valley, CA 92308 | 2011-11-29 |
| 1043508559 | Southern California Primary Medical Inc | Clinic/Center | 19341 Bear Valley Rd Ste 101, Apple Valley, CA 92308 | 2011-07-18 |
| 1396070959 | Asghar Ali Rajani | Registered Nurse | 19059 Bear Valley Road, Apple Valley, CA 92308 | 2009-10-14 |
| Find all providers in zip 92308 | ||||
| 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 |
|---|---|---|---|---|
| 1245385863 | High Desert Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 15448 Mondamon Rd, Apple Valley, CA 92307-4557 | 2007-01-24 |
| 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 | APPLE VALLEY |
| Zip Code | 92308 |
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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.