NPIMap

Organization Active NPI

Heavenly Haven

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Baton Rouge, LA
National Provider Identifier
1861515009
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
7259 Issued in LA
Legal business name
HEAVENLY HAVEN
Practice address
4824 E Brookstown Dr
Baton Rouge, LA 70805-3823
Phone
(225) 357-7206
Fax
(225) 357-6424
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Mrs. Dorothy M Nelson
Title
Ceo
Phone
(225) 357-5126

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 7259 LA Primary

Addresses

Primary practice location

4824 E Brookstown Dr
Baton Rouge, LA 70805-3823

Mailing address

4824 E Brookstown Dr
Baton Rouge, LA 70805-3823
Phone (225) 357-7206

Other identifiers 1

IdentifierTypeStateIssuer
1428744MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Heavenly Haven16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1861515009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4824 E BROOKSTOWN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708053823",
            "telephone_number": "225-357-7206",
            "fax_number": "225-357-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 E BROOKSTOWN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708053823",
            "telephone_number": "225-357-7206",
            "fax_number": "225-357-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-357-5126",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "7259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1428744",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.