HEAVENLY HAVEN (NPI# 1295284727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295284727 |
| Entity Type | Organization |
| Organization Name | HEAVENLY HAVEN |
| Practice Address |
4748 Clover St Unit A Houston TX 77033-4047 |
| Practice Telephone | 8324338433 |
| Mailing Telephone | 8324338433 |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |
| Authorized Official Name | ANDREA DYER (OWNER/CEO) |
| Authorized Official Telephone | 8324338433 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 261QM0850X | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871044925 | Heavenly Haven | Clinic/Center | 4748 Clover St, Unit A, Houston, TX 77033-4047 | 2016-10-24 |
| 1306005996 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-06-09 |
| 1659544377 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-04-03 |
| 1174794325 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-03-17 |
| 1487825741 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2008-03-14 |
| 1740489152 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-07-16 |
| 1093913485 | Heavenly Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-07-06 |
| 1659577922 | Heavenly Haven | Home Health | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-06-25 |
| 1952424194 | Heavenly Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-04-10 |
| 1861515009 | Heavenly Haven | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4824 E Brookstown Dr, Baton Rouge, LA 70805-3823 | 2007-04-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | HEAVENLY HAVEN LLC | 1823 N Center Ln, Po Box 11701, Spokane Valley, WA 99211 |
| Colorado Business Entities | Heavenly Haven LLC | 4527 Palmer Park Blvd, Colorado Springs, CO 80915 |
| Street Address |
4748 CLOVER ST UNIT A |
| City | HOUSTON |
| State | TX |
| Zip Code | 77033-4047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871044925 | Heavenly Haven | Clinic/Center | 4748 Clover St, Unit A, Houston, TX 77033-4047 | 2016-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972152023 | Mary L Jones | Technician | 7334 Bastogne Rd., Houston, TX 77033 | 2019-09-10 |
| 1518480813 | Divine Purpose Care Home, LLC | Assisted Living Facility | 5742 Schevers St, Houston, TX 77033 | 2017-07-19 |
| 1669928321 | Jernigan's Medical Services | Home Health | 5910 Kenilwood Drive, Houston, TX 77033 | 2016-08-31 |
| 1356641005 | Jericho House LLC | Assisted Living Facility | 4845 Rue Street, Houston, TX 77033 | 2010-10-28 |
| 1710109004 | Mar Vir Ley Selections | Non-emergency Medical Transport (VAN) | 7723 Belgard Street, Houston, TX 77033 | 2007-05-03 |
| 1134231046 | C & L Pharmacy | Pharmacy | 5600 Mykawa, Houston, TX 77033 | 2006-08-31 |
| 1083104806 | Life Changing Assistance Healthcare, LLC | Home Health | 5025 Doolittle Blvd, Houston, TX 77033 | 2018-05-16 |
| 1245742758 | Odalis Lizeth Valdez | Nurse Practitioner | 5515 South Loop E, Houston, TX 77033 | 2017-10-25 |
| 1124423736 | Deontology | Exclusive Provider Organization | 6022 Belneath St, Houston, TX 77033 | 2014-10-24 |
| 1326002080 | Physicians Dialysis of Houston LLP | Clinic/Center | 5989 South Loop E, Houston, TX 77033-1017 | 2006-04-12 |
| Find all providers in zip 77033 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1699239483 | Bee Focus Iop, LLC | Clinic/Center | 1616 Pech Rd Ste 100, Houston, TX 77055-3306 | 2019-01-25 |
| 1366921371 | Cp Therapy | Clinic/Center | 12238 Queenston Blvd, Houston, TX 77095-5329 | 2018-08-09 |
| 1871006643 | Houston Intimacy and Attachment Institute | Clinic/Center | 16310 Luzerne Dr Unit C, Houston, TX 77070-1726 | 2017-11-14 |
| 1063939742 | Family Alliance Network LLC | Clinic/Center | 5206 Cypress Creek Pkwy Ste 104, Houston, TX 77069-4405 | 2017-08-24 |
| 1013447580 | Nubeginning Tms Centers, LLC | Clinic/Center | 11500 Northwest Fwy Ste 581, Houston, TX 77092-6524 | 2017-06-15 |
| 1699205666 | Nubeginning Tms Centers, LLC | Clinic/Center | 11500 Northwest Fwy Ste 281, Houston, TX 77092-6521 | 2017-06-13 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.