NPIMap

Organization Active NPI

Beautiful Haven LLC

  • Assisted Living Facility
  • Laveen, AZ
National Provider Identifier
1063978211
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
BEAUTIFUL HAVEN LLC
Practice address
4804 W St Kateri Dr
Laveen, AZ 85339-8202
Phone
(602) 831-8280
NPI assigned
Feb 13, 2019
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Tesfaye TesemaNPI 1619717105
Title
Member
Phone
(602) 831-8280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

4804 W St Kateri Dr
Laveen, AZ 85339-8202

Mailing address

4804 W St Kateri Dr
Laveen, AZ 85339-8202
Phone (602) 831-8280

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1550016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1063978211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 W ST KATERI DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853398202",
            "telephone_number": "602-831-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4804 W ST KATERI DR",
            "city": "LAVEEN",
            "state": "AZ",
            "postal_code": "853398202",
            "telephone_number": "602-831-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTIFUL HAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-13",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "TESEMA",
        "authorized_official_first_name": "TESFAYE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "602-831-8280"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laveen, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.