Provider Demographics
NPI:1871339192
Name:HARMONY HAVEN RESIDENTIAL LIVING LLC
Entity type:Organization
Organization Name:HARMONY HAVEN RESIDENTIAL LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUBUNMI
Authorized Official - Middle Name:DEBORAH
Authorized Official - Last Name:CANTERBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-491-7611
Mailing Address - Street 1:17350 STATE HIGHWAY 249 STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1132
Mailing Address - Country:US
Mailing Address - Phone:469-491-7611
Mailing Address - Fax:
Practice Address - Street 1:3009 PENNY LN
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-7826
Practice Address - Country:US
Practice Address - Phone:469-491-7611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-05
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health