Provider Demographics
NPI:1114463064
Name:HAVILAH CARE
Entity Type:Organization
Organization Name:HAVILAH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FUNMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-510-7982
Mailing Address - Street 1:5001 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-4904
Mailing Address - Country:US
Mailing Address - Phone:609-510-7982
Mailing Address - Fax:
Practice Address - Street 1:5001 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-4904
Practice Address - Country:US
Practice Address - Phone:609-510-7982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOUSEHOLD OF FAITH ARLINGTON CHARITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable