Provider Demographics
NPI:1437710035
Name:GREAT HAVEN CARE LLC
Entity Type:Organization
Organization Name:GREAT HAVEN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROGRAM MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:IFY
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:832-876-5908
Mailing Address - Street 1:3138 W HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-3454
Mailing Address - Country:US
Mailing Address - Phone:832-876-5908
Mailing Address - Fax:
Practice Address - Street 1:3138 W HAMPTON DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-3454
Practice Address - Country:US
Practice Address - Phone:832-876-5908
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care