Provider Demographics
NPI:1871224683
Name:HAVANA'S HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:HAVANA'S HOME HEALTHCARE LLC
Other - Org Name:AT YOUR SIDE HOME CARE - NORTHWEST METRO HOUSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:URENDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-771-4425
Mailing Address - Street 1:2907 BIRCH PARK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-3116
Mailing Address - Country:US
Mailing Address - Phone:408-771-4425
Mailing Address - Fax:
Practice Address - Street 1:8203 WILLOW PLACE DR S STE 345
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5655
Practice Address - Country:US
Practice Address - Phone:408-771-4425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty