Haven Behavioral Services of Phoenix, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

BH-3156 Issued in AZ

Legal business name

HAVEN BEHAVIORAL SERVICES OF PHOENIX, LLC

Doing business as

Haven Senior Horizons Outpatient

Practice address

16620 N 40TH St
Suite I-1
Phoenix, AZ 85032-3348

Phone

(602) 923-5845

Fax

(602) 923-5846

NPI assigned

Jun 17, 2008

Organization subpart

No

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

Authorized official

Name

Mr. William Page Barnes

Title

Cfo/Secretary

Phone

(615) 250-9091

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Haven Senior Horizons Outpatient Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Hospital certification: CCN 034020

Legal name

HAVEN BEHAVIORAL SERVICES OF PHOENIX LLC

Doing business as

HAVEN BEHAVIORAL HOSPITAL OF PHOENIX

Certification status

Active

Provider type (POS)

Hospital – Psychiatric

Participating since

Aug 26, 1994

Last certification

Jul 17, 2024

Beds

57

Ownership / control type

Private (for profit)

Most recent change of ownership

Jun 30, 2008 (3 total)

Organization structure

LLCProprietary

Enrollment address

1201 S 7TH Ave
Ste 200
Phoenix, AZ 85007-4076
Other Hospital Practice Location

Hospital subgroups

Psychiatric

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Haven Behavioral Services of Phoenix, LLC

  • Psychiatric Hospital
  • Phoenix, AZ
  • NPI 1275716896

  O20080728000363

  Same enrollment

Listed as

Haven Behavioral Hospital of PhoenixCCN 034020 · All quality measures

Type

Psychiatric

Ownership

Proprietary

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

No

Locations

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 1

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

• Haven Behavioral Services of Phoenix, LLC

  • Psychiatric Hospital
  • Phoenix, AZ
  • NPI 1275716896

  5% Or Greater Direct Ownership Interest

  CMS ownership

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248998400000",
    "number": "1083875660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 W IRIS DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372043191",
            "telephone_number": "615-250-9500",
            "fax_number": "615-250-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST",
            "address_2": "SUITE I-1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323348",
            "telephone_number": "602-923-5845",
            "fax_number": "602-923-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN BEHAVIORAL SERVICES OF PHOENIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2009-07-31",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PAGE",
        "authorized_official_title_or_position": "CFO/SECRETARY",
        "authorized_official_telephone_number": "615-250-9091",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "AZ",
            "license": "BH-3156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "442893",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haven Senior Horizons Outpatient",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Saraselene Hausman, L.AC.
• Karen Grace Hausteen, RNFA
• Lauren Lehne Havard, M.D.
• Have Faith Hospice Services Inc
• Haven Behavioral Services of Phoenix West, LLC
• Haven Behavioral Services of Phoenix, LLC
• Haven Health Sky Harbor LLC
• Haven of Phoenix, LLC
• Havenhands PLLC
• Courtney Jane Havens-Mitchell, ATC

• Adult Mental Health Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Adult Mental Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.