Organization Active NPI

Havenrise Academy Holdings, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1427943828
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
HAVENRISE ACADEMY HOLDINGS, LLC
Practice address
10550 Deerwood Park Blvd Ste 301
Jacksonville, FL 32256-2805
Phone
(904) 352-0682
NPI assigned
Jun 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Mrs. Jamie Stevens
Title
Ceo
Phone
(904) 993-1559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

10550 Deerwood Park Blvd Ste 301
Jacksonville, FL 32256-2805

Mailing address

10550 Deerwood Park Blvd Ste 301
Jacksonville, FL 32256-2805
Phone (904) 352-0682

National Provider Directory

National Provider Directory

Locations

10550 Deerwood Park Blvd
Ste 301
Jacksonville, FL 32256
Phone (904) 352-0682

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.

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1427943828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10550 DEERWOOD PARK BLVD STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562805",
            "telephone_number": "904-352-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 DEERWOOD PARK BLVD STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562805",
            "telephone_number": "904-352-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVENRISE ACADEMY HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-993-1559",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.