Happy Haven2 Az, LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

HAPPY HAVEN2 AZ, LLC

Practice address

811 E Seldon LN
Phoenix, AZ 85020-3255

Phone

(207) 344-8204

NPI assigned

May 6, 2022

Last updated

May 7, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gloria Ndayishimiye

Title

Administrator

Phone

(207) 344-8204

Specialties & licenses 1

Addresses

Other names 1

• Happy haven2 AZ, LLC Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651881600000",
    "number": "1053057794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 E SELDON LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850203255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 E SELDON LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850203255",
            "telephone_number": "207-344-8204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAPPY HAVEN2 AZ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-07",
        "certification_date": "2022-05-07",
        "status": "A",
        "authorized_official_last_name": "NDAYISHIMIYE",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "207-344-8204"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Happy haven2 AZ, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.