# HIGH DESERT HAVEN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245385863
- **Authorized official:** MR. TRACEY ALLEN GRAHAM (FACILITY MANAGER)
- **Authorized official phone:** (760) 240-9896

## Contact information

- **Practice address:** 15448 MONDAMON RD, APPLE VALLEY, CA 92307-4557
- **Practice address phone:** (760) 240-9896
- **Practice address fax:** (760) 240-9876
- **Mailing address:** PMB 201, 20162 HWY 18, STE G, APPLE VALLEY, CA 92307
- **Mailing address phone:** (760) 240-9896
- **Mailing address fax:** (760) 240-9876

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | CA | Yes |

## Other

- **Enumeration date:** 01/24/2007
- **Last updated:** 08/22/2020