Provider Demographics
NPI:1023204179
Name:GRIFFIN HOME CARE HAVEN
Entity Type:Organization
Organization Name:GRIFFIN HOME CARE HAVEN
Other - Org Name:GRIFFIN HOME CARE HAVEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRENCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:214-725-8332
Mailing Address - Street 1:1208 WHISPERING CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75241-2035
Mailing Address - Country:US
Mailing Address - Phone:214-372-6831
Mailing Address - Fax:214-372-1743
Practice Address - Street 1:1208 WHISPERING CIR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241-2035
Practice Address - Country:US
Practice Address - Phone:214-372-6831
Practice Address - Fax:214-372-1743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-22
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142149310400000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility