NPIMap

Organization Active NPI

Haven of Sedona, LLC

Doing business as Haven of Sedona

  • Skilled Nursing Facility
  • Sedona, AZ
National Provider Identifier
1073178976
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HAVEN OF SEDONA, LLC
Doing business as
Haven of Sedona
Haven of Sedona, LLC
Practice address
505 Jacks Canyon Rd
Sedona, AZ 86351-7856
Phone
(928) 284-1000
NPI assigned
May 6, 2019
Last updated
Jan 23, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
HAVEN HEALTH GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Authorized official

Name
Brett P Robertson
Title
Ceo
Phone
(801) 296-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

505 Jacks Canyon Rd
Sedona, AZ 86351-7856

Mailing address

505 Jacks Canyon Rd
Sedona, AZ 86351-7856
Phone (928) 284-1000

Other identifiers 1

IdentifierTypeStateIssuer
590852MedicaidAZ

Other names 2

  • Haven of Sedona Doing business as
  • Haven of Sedona, LLC Doing business as

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
O20190718001288 AZ Part A Provider - Skilled Nursing Facility 3678808219 Practice locations: Sedona, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073178976. Details of each certification follow.

Skilled nursing facility certification: CCN 035094

Legal name
HAVEN OF SEDONA LLC
Doing business as
HAVEN OF SEDONA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 30, 1984
Last certification
Apr 9, 2025
Beds
112
Ownership / control type
Corporation
Multi-facility organization
Health Management Group
Organization structure
LLCProprietary
Enrollment address
505 Jacks Canyon Rd
Sedona, AZ 86351-7856
Nursing home name
HAVEN OF SEDONA
Affiliated entity
HAVEN HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Haven of SedonaCCN 035094 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 30, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11290.2 residents per day on average
Chain
Haven Health20 facilities in the chain
Special focus status
SFF Candidate
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Part of
Haven Health Group LLC

Ownership & related parties

All disclosed owners & managing parties 19

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 Indirect Ownership InterestMember Jul 1, 2019 6.4%
Operational/Managerial Control Jul 1, 2019
Adp of the SNF Jul 1, 2019
Indirect Ownership Interest Jul 1, 2019 6.4%
Haven Health Properties LLC Organization, Laguna Beach, CA Created for acquisition 5% Or Greater Mortgage Interest Jul 1, 2019 100%
Adp of the SNF Nov 25, 2024
Emily Dulas Individual Operational/Managerial Control Sep 10, 2018
Adp of the SNF Sep 10, 2018
Stephen Samuelian Individual 5% Or Greater Indirect Ownership InterestManager Jul 1, 2019 36.73%
Operational/Managerial Control Jul 1, 2019
Adp of the SNF Jul 1, 2019
Indirect Ownership Interest Jul 1, 2019 36.73%
Robert Samuelian Individual 5% Or Greater Indirect Ownership InterestManager Jul 1, 2019 20.13%
Operational/Managerial Control Jul 1, 2019
Adp of the SNF Jul 1, 2019
Indirect Ownership Interest Jul 1, 2019 20.13%
Erin Lee McCullough Individual Operational/Managerial Control Jan 1, 2021
Adp of the SNF Jan 1, 2021
Patrick Salvatore Sciara Individual Operational/Managerial Control Jan 1, 2021
Adp of the SNF Jan 1, 2021
Spencer R Samuelian Individual 5% Or Greater Indirect Ownership InterestManager Jul 1, 2019 25.21%
Operational/Managerial Control Jul 1, 2019
Adp of the SNF Jul 1, 2019
Indirect Ownership Interest Jul 1, 2019 25.21%
Stephanie Espinosa Individual Operational/Managerial Control Oct 14, 2024
Adp of the SNF Oct 14, 2024
Ternion Physician Group, PLLC Organization, Anthem, AZ LLC Operational/Managerial Control Jan 23, 2025
Adp of the SNF Jan 23, 2025
Stephanie Schumaker Individual Operational/Managerial Control Jul 5, 2023
Adp of the SNF Jul 5, 2023
Vicente Figueroa-Diaz Individual Operational/Managerial Control Jan 1, 2021
Adp of the SNF Jan 1, 2021
Jason J Seastrand Individual Operational/Managerial Control Jul 1, 2019
Adp of the SNF Jul 1, 2019
Indirect Ownership Interest Jul 1, 2019 3.92%
Lindsay Fragoso Individual Operational/Managerial Control May 10, 2021
Adp of the SNF May 10, 2021
Brett P Robertson Individual 5% Or Greater Indirect Ownership InterestManager/President/Ceo Jul 1, 2019 7.61%
Operational/Managerial Control Jul 1, 2019
Adp of the SNF Jul 1, 2019
Indirect Ownership Interest Jul 1, 2019 7.61%
Haven Health Group LLC Organization, Laguna Beach, CA LLC 5% Or Greater Direct Ownership Interest Jul 1, 2019 100%
Haven Sedona Real Estate LLC Organization, Laguna Beach, CA Created for acquisition, Owned by another organization or individual 5% Or Greater Mortgage Interest Jul 1, 2019 100%
Adp of the SNF Nov 26, 2024
Stock Longhurst Individual Operational/Managerial Control Nov 15, 2020
Adp of the SNF Nov 15, 2020
Health Group Management LLC Organization, Laguna Beach, CA Management services company Operational/Managerial Control Nov 25, 2024
Adp of the SNF Nov 25, 2024

Owners & managing parties with NPI records 4

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, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1073178976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 JACKS CANYON RD",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863517856",
            "telephone_number": "928-284-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 JACKS CANYON RD",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863517856",
            "telephone_number": "928-284-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN OF SEDONA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAVEN HEALTH GROUP LLC",
        "enumeration_date": "2019-05-06",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-296-5100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590852",
            "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": [
        {
            "organization_name": "Haven of Sedona",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Haven of Sedona, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sedona, AZ

Sources for this page

Verify at the official NPI Registry.