OrganizationActive
Haynes Family of Programs
NPI 1164548236 · Mental Illness Community Based Residential Treatment Facility · La Verne, CA
Provider details
- NPI number
- 1164548236
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Daniel Maydeck, Chief Executive Officer(909) 593-2581
Specialties & taxonomies
- Mental Illness Community Based Residential Treatment FacilityPrimary320800000XLicense 191501972 (CA)
Residential Treatment Facilities
- Behavior Analyst103K00000X
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(94/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1350 3rd St
La Verne, CA 91750-5201
Phone: (909) 593-2581
Fax: (909) 596-3567
Street-level locationGet directions
Mailing address
1350 3rd St
La Verne, CA 91750-5201
Other names (DBA / former)
- Other name
- Leroy Haynes Center
- Other name
- Leroy Haynes Center
Additional practice locations (1)
- 1025 Sentinel Dr Ste 200 & 206La Verne, CA 91750-3282Phone: (909) 833-2986Fax: (909) 614-7466
Registry dates
- Enumerated
- 2007-03-21
- Last updated
- 2021-04-12
- Certified
- 2021-04-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.