NPIMap

Organization Active NPI

Haven of Sierra Vista, LLC

Doing business as Haven of Sierra Vista

  • Skilled Nursing Facility
  • Sierra Vista, AZ
National Provider Identifier
1720506926
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HAVEN OF SIERRA VISTA, LLC
Doing business as
Haven of Sierra Vista
Practice address
660 S Coronado Dr
Sierra Vista, AZ 85635-3386
Phone
(520) 459-4900
Fax
(801) 296-5111
NPI assigned
Sep 7, 2017
Organization subpart
Yes
Parent organization
HAVEN HEALTH GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Authorized official

Name
Mr. Brett P Robertson
Title
Ceo
Phone
(480) 935-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

660 S Coronado Dr
Sierra Vista, AZ 85635-3386

Mailing address

660 S Coronado Dr
Sierra Vista, AZ 85635-3386
Phone (520) 459-4900

Other identifiers 1

IdentifierTypeStateIssuer
432588MedicaidAZ

Other names 1

  • Haven of Sierra Vista Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171206003348 AZ Part A Provider - Skilled Nursing Facility 6406113067 Practice locations: Sierra Vista, AZ

Skilled nursing facility certification: CCN 035086

Legal name
HAVEN OF SIERRA VISTA LLC
Doing business as
HAVEN HEALTH GROUP LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 22, 1983
Last certification
Dec 8, 2023
Beds
100
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Haven Health Group
Organization structure
LLCProprietary
Enrollment address
660 S Coronado Dr
Sierra Vista, AZ 85635-3386
Nursing home name
HAVEN OF SIERRA VISTA, LLC
Affiliated entity
HAVEN HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Haven of Sierra Vista, LLCCCN 035086 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jun 22, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10089.7 residents per day on average
Chain
Haven Health20 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D0532024Haven of Sierra Vista LLC660 S Coronado Dr, Sierra Vista, AZ 85635Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Part of
Haven Health Group LLC

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christian R West Individual 5% Or Greater Direct Ownership InterestMember Nov 1, 2017 6.4%
Operational/Managerial Control Nov 1, 2017
Adp of the SNF Nov 1, 2017
Direct Ownership Interest Nov 1, 2017 6.4%
Haven Health Properties LLC Organization, Laguna Beach, CA Created for acquisition 5% Or Greater Mortgage Interest Nov 1, 2017 100%
Adp of the SNF Nov 26, 2024
Russell Greiner Individual Operational/Managerial Control Aug 16, 2023
Adp of the SNF Aug 16, 2023
Stephen Samuelian Individual 5% Or Greater Direct Ownership InterestManager/President/Ceo Nov 1, 2017 36.73%
Operational/Managerial Control Jan 10, 2025
Adp of the SNF Jan 20, 2025
Direct Ownership Interest Nov 1, 2017 36.73%
Monica R Vandivort Individual Operational/Managerial Control Jun 1, 2023
Adp of the SNF Jun 1, 2023
Haven Sierra Vista Real Estate LLC Organization, Laguna Beach, CA Created for acquisition, Owned by another organization or individual 5% Or Greater Mortgage Interest Nov 1, 2017 100%
Adp of the SNF Nov 26, 2024
Robert Samuelian Individual 5% Or Greater Direct Ownership InterestManager Nov 1, 2017 20.13%
Operational/Managerial Control Jan 10, 2025
Adp of the SNF Jan 20, 2025
Direct Ownership Interest Nov 1, 2017 20.13%
Spencer R Samuelian Individual 5% Or Greater Direct Ownership InterestManager Nov 1, 2017 25.21%
Operational/Managerial Control Nov 1, 2017
Adp of the SNF Nov 1, 2017
Direct Ownership Interest Nov 1, 2017 25.21%
Stephanie Espinosa Individual Operational/Managerial Control Oct 14, 2024
Adp of the SNF Oct 14, 2024
Karla Aguilar Individual Operational/Managerial Control May 18, 2021
Adp of the SNF May 18, 2021
Mark Muir Individual Operational/Managerial Control Nov 1, 2017
Adp of the SNF Nov 1, 2017
Deedee Ramon Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Jason J Seastrand Individual Operational/Managerial Control Nov 1, 2017
Adp of the SNF Nov 1, 2017
Direct Ownership Interest Nov 1, 2017 3.92%
Lindsay Fragoso Individual Operational/Managerial Control May 10, 2021
Adp of the SNF May 10, 2021
Brett P Robertson Individual 5% Or Greater Direct Ownership InterestManager/President/Ceo Nov 1, 2017 7.61%
Operational/Managerial Control Nov 1, 2017
Adp of the SNF Nov 1, 2017
Direct Ownership Interest Nov 1, 2017 7.61%
Haven Health Group LLC Organization, Laguna Beach, CA LLC 5% Or Greater Direct Ownership Interest Oct 31, 2017 100%
Indirect Ownership Interest Oct 31, 2017 100%
Stock Longhurst Individual Operational/Managerial Control Nov 15, 2020
Adp of the SNF Nov 15, 2020
Health Group Management LLC Organization, Laguna Beach, CA Management services company Operational/Managerial Control Nov 21, 2024
Adp of the SNF Nov 21, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 30

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 30

Practitioners & affiliated clinicians

Practitioners 3

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

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769126400000",
    "number": "1720506926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S CORONADO DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856353386",
            "telephone_number": "520-459-4900",
            "fax_number": "801-296-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S CORONADO DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856353386",
            "telephone_number": "520-459-4900",
            "fax_number": "801-296-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN OF SIERRA VISTA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HAVEN HEALTH GROUP LLC",
        "enumeration_date": "2017-09-07",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-935-4300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432588",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Haven of Sierra Vista",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Haven of Sierra Vista",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.