GREEN HAVEN GROUP HOME NPI 1174206957

NPI Information

  • NPI: 1174206957
  • Provider Name: GREEN HAVEN GROUP HOME
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 3111 CREEKWOOD DR
    WYLIE, TX
    ZIP 75098
  • Phone: (408) 561-2324

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NPI Details

GREEN HAVEN GROUP HOME is an assisted living facility in Wylie, TX. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. GREEN HAVEN GROUP HOME NPI is 1174206957. The provider is registered as an organization entity type.

The provider's business location address is:

3111 CREEKWOOD DR
WYLIE, TX
ZIP 75098-339
Phone: (408) 561-2324

The provider's authorized official is Ali Adem .
The authorized official title is Manager and has the following contact phone number (408) 561-2324.

The enumeration date for this NPI number is 8/9/2023 and was last updated on 8/9/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

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: 11/21/2025

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