Autumn Haven Residential Facility
Assisted Living Facility in Dallas, TX. Organization (NPI-2).
NPI number1710692736
StatusActive
Last updated in NPPESJan 16, 2023
Details
- NPI
- 1710692736
- Entity type
- Organization (NPI-2)
- Legal business name
- Autumn Haven Residential Facility
- Organization subpart
- No
- Enumeration date
- Jan 16, 2023
- Certification date
- Jan 14, 2023
- Last updated
- Jan 16, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
| 3104A0625X | Assisted Living Facility, Assisted Living, Mental Illness | – | – | |
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – |
Other names
- Habor Haven Home Healthcare Services LLC (Other Name)
Practice location
2507 Earlcove DrDallas, TX 75227-7817
Phone 469-992-0389 · Fax 972-637-9225
Mailing address
2507 Earlcove DrDallas, TX 75227-7817
Phone 469-992-0389 · Fax 972-637-9225
Authorized official
Alicia Dennis
Owner
4692541298
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