Active NPI
Heavenly Haven
- Adult Care Home Facility
- Houston, TX
National Provider Identifier
1871044925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- Legal business name
- HEAVENLY HAVEN
- Practice address
- 4748 Clover St
Unit a
Houston, TX 77033-4047 - Phone
- (832) 433-8433
- NPI assigned
- Oct 24, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Andrea Dyer
- Title
- Ceo/Owner
- Phone
- (832) 433-8433
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Adult Care Home Facility | 311ZA0620X | Primary |
Addresses
Primary practice location
4748 Clover St
Unit a
Houston, TX 77033-4047
Mailing address
4748 Clover St
Unit a
Houston, TX 77033-4047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649628033 | Medicaid | TX |
National Provider Directory
National Provider Directory- Tax ID family
- Heavenly Haven
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Mental Health Clinic/Center
- Houston, TX
- NPI 1295284727
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Mental Health Clinic/Center
- Houston, TX
- NPI 1649628033
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477267200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1550793600000",
"number": "1871044925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4748 CLOVER ST",
"address_2": "UNIT A",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770334047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4748 CLOVER ST",
"address_2": "UNIT A",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770334047",
"telephone_number": "832-433-8433"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEAVENLY HAVEN",
"organizational_subpart": "NO",
"enumeration_date": "2016-10-24",
"last_updated": "2019-02-22",
"status": "A",
"authorized_official_last_name": "DYER",
"authorized_official_first_name": "ANDREA",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "832-433-8433"
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1649628033",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.