NPIMap

Organization Active NPI

Haven of Yuma, LLC

  • Skilled Nursing Facility
  • Yuma, AZ
National Provider Identifier
1053715839
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HAVEN OF YUMA, LLC
Practice address
2470 S Arizona Ave
Yuma, AZ 85364-8520
Phone
(801) 296-5100
NPI assigned
Oct 22, 2014
Organization subpart
Yes
Parent organization
HAVEN HEALTH GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Brett Robertson
Title
Ceo
Phone
(480) 935-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2470 S Arizona Ave
Yuma, AZ 85364-8520

Mailing address

2470 S Arizona Avenue
Yuma, AZ 85364
Phone (801) 296-5100

Other identifiers 1

IdentifierTypeStateIssuer
011785MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150127002001 AZ Part A Provider - Skilled Nursing Facility 4880918671 Practice locations: Yuma, AZ

Skilled nursing facility certification: CCN 035197

Legal name
HAVEN OF YUMA LLC
Doing business as
HEALTH GROUP MANAGEMENT
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 20, 1989
Last certification
Jun 23, 2023
Beds
120
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Health Group Management
Organization structure
LLCProprietary
Incorporated
Jun 30, 2014 in AZ
Enrollment address
2470 Arizona Ave
Yuma, AZ 85364-8520
Nursing home name
HAVEN OF YUMA
Affiliated entity
HAVEN HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Haven of YumaCCN 035197 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 20, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120102.7 residents per day on average
Chain
Haven Health20 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D0878890Haven of Yuma LLC2470 Arizona Avenue, Yuma, AZ 85364Certificate of waiverNov 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Esolutions Inc2 organizations share this tax ID, including this one
Part of
Haven Health Group LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christian R West Individual 5% Or Greater Direct Ownership InterestManager Nov 9, 2014 6.4%
Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 15, 2025
Direct Ownership Interest Nov 1, 2014 6.4%
Mohemed M El Amin Individual Operational/Managerial Control Jan 15, 2025
Adp of the SNF Jan 15, 2025
Stephen Samuelian Individual 5% Or Greater Direct Ownership InterestManager Nov 9, 2014 36.73%
Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 15, 2025
Direct Ownership Interest Nov 1, 2014 36.73%
Robert Samuelian Individual 5% Or Greater Direct Ownership InterestManager Nov 9, 2014 20.13%
Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 15, 2025
Direct Ownership Interest Nov 1, 2014 20.13%
Spencer R Samuelian Individual 5% Or Greater Direct Ownership InterestManager Nov 9, 2014 25.21%
Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 15, 2025
Direct Ownership Interest Nov 1, 2014 25.21%
Stephanie Espinosa Individual Corporate OfficerChief Nursing Officer Oct 14, 2024
Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 8, 2025
Samuel Loveless Individual Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 8, 2025
Mark Muir Individual Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 8, 2025
Globe-Yuma Real Estate Partners Organization, Laguna Beach, CA Created for acquisition 5% Or Greater Mortgage Interest Nov 1, 2014 100%
Adp of the SNF Nov 26, 2024
Jason J Seastrand Individual 5% Or Greater Direct Ownership InterestManager Nov 9, 2014 3.92%
Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 15, 2025
Direct Ownership Interest Nov 1, 2014 3.92%
Lindsay Fragoso Individual Corporate OfficerLegal Council May 10, 2021
Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 8, 2025
Brett P Robertson Individual 5% Or Greater Direct Ownership InterestManager/President/Ceo Nov 1, 2014 7.61%
Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 15, 2025
Direct Ownership Interest Nov 1, 2014 7.61%
Haven Health Group Globe Yuma LLC Organization, Laguna Beach, CA Created for acquisition, Owned by another organization or individual 5% Or Greater Mortgage Interest Nov 1, 2014 100%
Adp of the SNF Nov 26, 2024
Trevor Saxman Individual Operational/Managerial Control Jan 15, 2025
Adp of the SNF Jan 15, 2025
Brandon Fonseca Individual Operational/Managerial Control Jan 8, 2025
Adp of the SNF Jan 8, 2025
Haven Health Group LLC Organization, Laguna Beach, CA LLC 5% Or Greater Direct Ownership Interest Nov 9, 2014 100%
Health Group Management LLC Organization, Laguna Beach, CA Management services company Operational/Managerial Control Nov 21, 2024
Adp of the SNF Nov 21, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 30

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 30

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1053715839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2470 S ARIZONA AVENUE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "85364",
            "telephone_number": "801-296-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 S ARIZONA AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648520",
            "telephone_number": "801-296-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN OF YUMA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAVEN HEALTH GROUP LLC",
        "enumeration_date": "2014-10-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-935-4300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011785",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.