SURE HAVEN INC. (NPI# 1942545199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942545199 |
| Entity Type | Organization |
| Organization Name | SURE HAVEN INC. |
| Practice Address |
2900 Bristol St Costa Mesa CA 92626-5981 |
| Mailing Address |
2900 Bristol St Suite B202 Costa Mesa CA 92626-5981 |
| Practice Telephone | 7023059167 |
| Practice Fax Number | 9492095490 |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2018-12-28 |
| Authorized Official Name | STEVE FENNELLY (CEO) |
| Authorized Official Telephone | 7023059167 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CA DHCS | 300235QP | 01 |
| Street Address |
2900 BRISTOL ST |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-5981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417991498 | Burdetta Louise Honescko | Counselor | 2900 Bristol St, J101, Costa Mesa, CA 92626-5981 | 2006-06-16 |
| 1184244121 | James Marquez | Counselor | 2900 Bristol St, Costa Mesa, CA 92626-5981 | 2020-04-20 |
| 1659841609 | Steve G Baker | Counselor | 2900 Bristol St, Costa Mesa, CA 92626-5981 | 2018-12-03 |
| 1710452784 | We Care Path | Counselor | 2900 Bristol St, Costa Mesa, CA 92626-5981 | 2018-10-05 |
| 1821522053 | Manabu Kuzu | Acupuncturist | 2900 Bristol St, G103, Costa Mesa, CA 92626-5981 | 2017-04-14 |
| 1366982878 | Stephen Stylianides | Chiropractor | 2900 Bristol St, Suite J104, Costa Mesa, CA 92626-5981 | 2017-03-02 |
| 1063964476 | Carol J Timmons | Clinic/Center | 2900 Bristol St, Bldg. J-206, Costa Mesa, CA 92626-5981 | 2016-11-02 |
| 1821449109 | Paige Meyer | Chiropractor | 2900 Bristol St, J108, Costa Mesa, CA 92626-5981 | 2016-06-28 |
| 1558712448 | The Body Lab Physical Therapy Inc. | Physical Therapist | 2900 Bristol St, J104, Costa Mesa, CA 92626-5981 | 2016-06-22 |
| 1518321439 | Lisa Ann Maurel | Marriage & Family Therapist | 2900 Bristol St, Suite C 208, Costa Mesa, CA 92626-5981 | 2016-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538782198 | Asana Recovery | Substance Abuse Rehabilitation Facility | 3062 Johnson Ave, Costa Mesa, CA 92626-2819 | 2020-05-18 |
| 1720644602 | The Stephouse Recovery, Inc. | Substance Abuse Rehabilitation Facility | 1601 Baker St, Costa Mesa, CA 92626-3701 | 2019-05-15 |
| 1689137689 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 1509 Orange Ave # A, Costa Mesa, CA 92627-3718 | 2019-04-08 |
| 1770046773 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 1509 Orange Ave # B, Costa Mesa, CA 92627-3718 | 2019-04-08 |
| 1740742840 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 317 Rochester St, Costa Mesa, CA 92627-3113 | 2019-04-05 |
| 1245791961 | National Therapeutic Services, Inc | Substance Abuse Rehabilitation Facility | 131 E Wilson St, Costa Mesa, CA 92627-9455 | 2019-03-26 |
| 1134680853 | National Therapeutic Services, Inc | Substance Abuse Rehabilitation Facility | 2417 Orange Ave, Costa Mesa, CA 92627-5102 | 2019-03-26 |
| 1598226219 | National Therapeutic Services, Inc | Substance Abuse Rehabilitation Facility | 321 Cabrillo St, Costa Mesa, CA 92627-3122 | 2019-03-26 |
| 1316408032 | National Therapeutic Services, Inc | Substance Abuse Rehabilitation Facility | 327 Cabrillo St, Costa Mesa, CA 92627-3123 | 2019-03-26 |
| 1104391127 | Windward Way Recovery LLC | Substance Abuse Rehabilitation Facility | 2136 Thurin St Unit A, Costa Mesa, CA 92627-6067 | 2018-10-05 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
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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.