Active NPI
Haven Behavioral Services of Albuquerque, LLC
Doing business as Haven Behavioral Hospital of Albuquerque
- Psychiatric Hospital
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- License
- 2T3426
- Legal business name
- HAVEN BEHAVIORAL SERVICES OF ALBUQUERQUE, LLC
- Doing business as
- Haven Behavioral Hospital of Albuquerque
- Practice address
- 5400 Gibson Blvd SE
4TH Floor
Albuquerque, NM 87108-4729 - Phone
- (615) 393-8826
- NPI assigned
- Jul 2, 2012
- Last updated
- Mar 24, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Laura Tarantino
- Title
- Evp
- Phone
- (972) 464-0022
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | 2T3426 | NM | Primary |
Addresses
Primary practice location
5400 Gibson Blvd SE
4TH Floor
Albuquerque, NM 87108-4729
Mailing address
3102 W End Ave
Suite 1000
Nashville, TN 37203-1301
Phone (615) 393-8826
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08652856 | Medicaid | NM |
Other names 1
- Haven Behavioral Hospital of Albuquerque
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 2
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1093079303. Details of each certification follow.
Hospital certification: CCN 324013
- Legal name
- HAVEN BEHAVIORAL SERVICES OF ALBUQUERQUE LLC
- Doing business as
- HAVEN BEHAVIORAL HOSPITAL OF ALBUQUERQUE
- Certification status
- Active
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Apr 17, 2013
- Last certification
- Feb 27, 2025
- Beds
- 48
- Ownership / control type
- Private (for profit)
- Organization structure
- LLC
- Enrollment address
- 5400 Gibson Blvd SE
Ste 4
Albuquerque, NM 87108-5181 - Hospital subgroups
- Psychiatric
Care Compare: Hospital
Medicare Care Compare- Listed as
- Haven Behavioral Hospital of Albuquerque
- Type
- Psychiatric
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- No
National Provider Directory
National Provider DirectoryOwnership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Kathleen Dostalik | W-2 Managing Employee | Sep 1, 2022 | |
| Oceans Midco, Inc. | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 100% |
| Haven Behavioral Services LLC | 5% Or Greater Direct Ownership Interest | Feb 16, 2012 | 100% |
| Oceans Topco, Inc. | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 100% |
| Oceans Ultimate Holdco, LP | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 100% |
| Haven Behavioral Healthcare Inc | 5% Or Greater Indirect Ownership Interest | Feb 16, 2012 | 100% |
| Oceans Ultimate Holdco GP, LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 1% |
| Wasque Partners II Spe, LP | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 9.31% |
| Webster Oceans Co-Investment Fund, LP | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 33.14% |
| Oceans Acquisition Inc | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 100% |
| Stuart L Archer | Corporate Officer | Jan 1, 2025 | |
| Laura F Tarantino | Corporate Officer | Jan 1, 2025 | |
| Webster Equity Partners V, LP | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 49.73% |
| Haven Behavioral Services Holdings LLC | 5% Or Greater Indirect Ownership Interest | Feb 16, 2012 | 100% |
| Oceans Buyer, Inc. | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 100% |
Facilities with the same owner 42
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Home Health Agency
- Allston, MA
- NPI 1720386378
Webster Equity Partners V, LP
-
dba Oceans Behavioral Hospital of Longview
- Psychiatric Hospital
- Longview, TX
- NPI 1306146733
Oceans Buyer, Inc., Oceans Midco, Inc., Oceans Topco, Inc., Oceans Ultimate Holdco GP, LLC, Oceans Ultimate Holdco, LP, Wasque Partners II Spe, LP, Webster Equity Partners V, LP, Webster Oceans Co-Investment Fund, LP
-
- Psychiatric Hospital
- Midland, TX
- NPI 1396184180
Oceans Acquisition Inc, Oceans Buyer, Inc., Oceans Midco, Inc., Oceans Topco, Inc., Oceans Ultimate Holdco GP, LLC, Oceans Ultimate Holdco, LP, Wasque Partners II Spe, LP, Webster Equity Partners V, LP, Webster Oceans Co-Investment Fund, LP
-
dba Behavioral Health Center at Porter Health Village
- Psychiatric Hospital
- Norman, OK
- NPI 1972385672
Oceans Acquisition Inc, Oceans Buyer, Inc., Oceans Midco, Inc., Oceans Topco, Inc., Oceans Ultimate Holdco GP, LLC, Oceans Ultimate Holdco, LP, Wasque Partners II Spe, LP, Webster Equity Partners V, LP, Webster Oceans Co-Investment Fund, LP
-
- Respite Care
- Washington, DC
- NPI 1225533086
Webster Equity Partners V, LP
-
- Home Health Agency
- Indianapolis, IN
- NPI 1437544475
Webster Equity Partners V, LP
-
dba Haven Behavioral Hospital of Dayton
- Psychiatric Hospital
- Dayton, OH
- NPI 1831460229
Haven Behavioral Healthcare Inc, Haven Behavioral Services Holdings LLC, Haven Behavioral Services LLC, Oceans Acquisition Inc, Oceans Buyer, Inc., Oceans Midco, Inc., Oceans Topco, Inc., Oceans Ultimate Holdco GP, LLC, Oceans Ultimate Holdco, LP
-
dba Haven Behavioral Hospital of Philadelphia
- Psychiatric Hospital
- Philadelphia, PA
- NPI 1912341629
Haven Behavioral Healthcare Inc, Haven Behavioral Services Holdings LLC, Haven Behavioral Services LLC, Oceans Acquisition Inc, Oceans Buyer, Inc., Oceans Midco, Inc., Oceans Topco, Inc., Oceans Ultimate Holdco GP, LLC, Oceans Ultimate Holdco, LP
-
dba Haven Behavioral Hospital of Phoenix
- Psychiatric Hospital
- Phoenix, AZ
- NPI 1275716896
Haven Behavioral Healthcare Inc, Haven Behavioral Services LLC, Oceans Acquisition Inc, Oceans Buyer, Inc., Oceans Midco, Inc., Oceans Topco, Inc., Oceans Ultimate Holdco GP, LLC, Oceans Ultimate Holdco, LP, Wasque Partners II Spe, LP, Webster Eq
-
dba Haven Behavioral Hospital of Eastern Pennsylvania
- Psychiatric Hospital
- Reading, PA
- NPI 1629384292
Haven Behavioral Healthcare Inc, Haven Behavioral Services Holdings LLC, Haven Behavioral Services LLC, Oceans Acquisition Inc, Oceans Buyer, Inc., Oceans Midco, Inc., Oceans Topco, Inc., Oceans Ultimate Holdco GP, LLC, Oceans Ultimate Holdco, LP
-
dba Haven Behavioral Hospital of West Chester
- Psychiatric Hospital
- West Chester, PA
- NPI 1376248369
Haven Behavioral Healthcare Inc, Haven Behavioral Services Holdings LLC, Haven Behavioral Services LLC, Oceans Acquisition Inc, Oceans Buyer, Inc., Oceans Midco, Inc., Oceans Topco, Inc., Oceans Ultimate Holdco GP, LLC, Oceans Ultimate Holdco, LP
-
dba Cottonwood Creek Behavioral Hospital
- Psychiatric Hospital
- Meridian, ID
- NPI 1003397878
Haven Behavioral Healthcare Inc, Haven Behavioral Services Holdings LLC, Haven Behavioral Services LLC, Oceans Acquisition Inc, Oceans Buyer, Inc., Oceans Midco, Inc., Oceans Topco, Inc., Oceans Ultimate Holdco GP, LLC, Oceans Ultimate Holdco, LP
Practitioners & affiliated clinicians
Practitioners 15
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.
-
- Clinical Social Worker
- Albuquerque, NM
- NPI 1194487884
-
- Nurse Practitioner
- Albuquerque, NM
- NPI 1396477311
-
- Clinical Social Worker
- Albuquerque, NM
- NPI 1588077416
-
- Psychiatry Physician
- Albuquerque, NM
- NPI 1679969497
-
- Clinical Social Worker
- Albuquerque, NM
- NPI 1821581125
-
- Psychiatric/Mental Health Nurse Practitioner
- Albuquerque, NM
- NPI 1013723923
-
- Professional Counselor
- Albuquerque, NM
- NPI 1003946526
-
- Clinical Social Worker
- Albuquerque, NM
- NPI 1073088142
-
- Clinical Social Worker
- Placitas, NM
- NPI 1679891600
-
- Clinical Social Worker
- Hobbs, NM
- NPI 1427653625
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341187200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1742774400000",
"number": "1093079303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3102 W END AVE",
"address_2": "SUITE 1000",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372031301",
"telephone_number": "615-393-8826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5400 GIBSON BLVD SE",
"address_2": "4TH FLOOR",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871084729",
"telephone_number": "615-393-8826"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAVEN BEHAVIORAL SERVICES OF ALBUQUERQUE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-02",
"last_updated": "2025-03-24",
"certification_date": "2025-03-24",
"status": "A",
"authorized_official_last_name": "TARANTINO",
"authorized_official_first_name": "LAURA",
"authorized_official_title_or_position": "EVP",
"authorized_official_telephone_number": "972-464-0022"
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "NM",
"license": "2T3426",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08652856",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Haven Behavioral Hospital of Albuquerque",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.