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HEAVENLY HAVEN NPI 1871044925


NPI Information

NPI: 1871044925
Provider Name: HEAVENLY HAVEN
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
4748 CLOVER ST
UNIT A
HOUSTON, TX
ZIP 77033
Phone: (832) 433-8433
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HEAVENLY HAVEN is an adult care home custodial care facility in Houston, TX. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. HEAVENLY HAVEN NPI is 1871044925. The provider is registered as an organization entity type.

The provider's business location address is:

4748 CLOVER ST
UNIT A
HOUSTON, TX
ZIP 77033-047
Phone: (832) 433-8433

The provider's authorized official is Andrea Dyer .
The authorized official title is Ceo/owner and has the following contact phone number (832) 433-8433.

The enumeration date for this NPI number is 10/24/2016 and was last updated on 2/22/2019.


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
1261QM0850XClinic/CenterAdult Mental HealthNo
2311ZA0620XCustodial Care FacilityAdult Care HomeYes

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
11649628033MEDICAIDTEXAS

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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