Haven Manor LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

HAVEN MANOR LLC

Practice address

13594 W Post Dr
Surprise, AZ 85374-5405

Phone

(623) 203-0771

NPI assigned

May 22, 2024

Organization subpart

No

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

Authorized official

Name

Virginia Nganga, LPN

Title

Operations Manager

Phone

(623) 203-0771

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1255170858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13594 W POST DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745405",
            "telephone_number": "623-203-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13594 W POST DR",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853745405",
            "telephone_number": "623-203-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "NGANGA",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "623-203-0771",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Surprise, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.