Sovereign Haven Assisted Living LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

L14634518 Issued in AZ

Legal business name

SOVEREIGN HAVEN ASSISTED LIVING LLC

Practice address

13436 W Berridge LN
Litchfield Park, AZ 85340-8323

Phone

(888) 651-9991

NPI assigned

Jun 14, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Maria A. Land

Title

Administrator

Phone

(888) 651-9991

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1598115115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13436 W BERRIDGE LN",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853408323",
            "telephone_number": "888-651-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13436 W BERRIDGE LN",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853408323",
            "telephone_number": "888-651-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HAVEN ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "LAND",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "888-651-9991",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "L14634518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.