Emerald Haven LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EMERALD HAVEN LLC

Practice address

3802 Tanchico Dr
Killeen, TX 76542-6924

Phone

(512) 760-2629

NPI assigned

Oct 26, 2026

Last updated

Oct 26, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Kizzy Simmons

Title

Owner

Phone

(512) 760-2629

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1792972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792972800000",
    "number": "1912805524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 TANCHICO DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765426924",
            "telephone_number": "512-760-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 TANCHICO DR",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765426924",
            "telephone_number": "512-760-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD HAVEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-26",
        "last_updated": "2026-10-26",
        "certification_date": "2026-10-26",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "KIZZY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-760-2629",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.