Provider Demographics
NPI:1114142668
Name:MANHAVEN HEALTHCARE LLC
Entity Type:Organization
Organization Name:MANHAVEN HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-403-6193
Mailing Address - Street 1:13002 BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4561
Mailing Address - Country:US
Mailing Address - Phone:281-403-6193
Mailing Address - Fax:866-317-2650
Practice Address - Street 1:13002 BONNIE LN
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4561
Practice Address - Country:US
Practice Address - Phone:281-403-6193
Practice Address - Fax:866-317-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health