NPIMap

Organization Active NPI

Harvest Safe Haven for Boys

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Riverside, CA
National Provider Identifier
1174132807
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
HARVEST SAFE HAVEN FOR BOYS
Practice address
5425 Sierra Vista Ave
Riverside, CA 92505-3113
Phone
(951) 715-3126
Fax
(951) 531-8605
NPI assigned
Jul 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Authorized official

Name
Mr. Daniel Park
Title
Executive Director
Phone
(951) 295-8239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

5425 Sierra Vista Ave
Riverside, CA 92505-3113

Mailing address

3380 La Sierra Ave Ste 104-242
Riverside, CA 92503-5271
Phone (951) 715-3126

National Provider Directory

National Provider Directory
Tax ID family
Harvest Safe Haven for Boys2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1174132807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 LA SIERRA AVE STE 104-242",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925035271",
            "telephone_number": "951-715-3126",
            "fax_number": "951-531-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 SIERRA VISTA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053113",
            "telephone_number": "951-715-3126",
            "fax_number": "951-531-8605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVEST SAFE HAVEN FOR BOYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "951-295-8239",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.