Haven Arizona, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

HAVEN ARIZONA, LLC

Practice address

3161 S Prosperous PL
Green Valley, AZ 85614-6403

Phone

(561) 635-2400

NPI assigned

Oct 20, 2023

Organization subpart

No

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

Authorized official

Name

Kirill Vesselov

Title

President

Phone

(561) 396-5849

Specialties & licenses 2

Addresses

Practitioners 1

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

• Karen Canulla, M.D.

  • Psychiatry Physician
  • Gravette, AR
  • NPI 1477758530
  NPD (past)

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

{
    "created_epoch": "1697760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1487436796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 10TH AVE N",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334613000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 S PROSPEROUS PL",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856146403",
            "telephone_number": "561-635-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-20",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "VESSELOV",
        "authorized_official_first_name": "KIRILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-396-5849"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hanger Prosthetics & Orthotics West, Inc.
• Rachel Tennessee Hardy, D.O.
• Harmony Palliative Care, LLC
• Thomas J Hausam, MD
• Haven Arizona Operating Subsidiary, LLC
• Haven Health Green Valley LLC
• Haven Springs at Green Valley LLC
• Healthquest of Green Valley LLC
• Tia Heng, MD
• Madaline Elyse Hoffman, PT, DPT

• All providers in Green Valley, AZ
• Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.