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HAVEN OF HOPE INC. NPI 1912495441


NPI Information

NPI: 1912495441
Provider Name: HAVEN OF HOPE, INC.

Other Name: HAVEN OF HOPE, INC - ABEONA

Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
2769 VALENCIA RD
APTOS, CA
ZIP 95003
Phone: (831) 425-3010
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HAVEN OF HOPE, INC. is a residential treatment facility emotionally disturbed children in Aptos, CA. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. HAVEN OF HOPE, INC. NPI is 1912495441. The provider is registered as an organization entity type.
The provider Other Name Is Haven Of Hope, Inc - Abeona.

The provider's business location address is:

2769 VALENCIA RD
APTOS, CA
ZIP 95003
Phone: (831) 425-3010
Fax: (831) 426-6348

The provider's authorized official is Davina Rene Polanco .
The authorized official title is Executive Director and has the following contact phone number (831) 425-3010.

The enumeration date for this NPI number is 4/30/2018 and was last updated on 5/17/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1322D00000XResidential Treatment Facility, Emotionally Disturbed Children445201743CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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