Green Haven Group Home

NPI #1174206957 in Wylie, Texas

Provider Information

NPI Number: 1174206957
Entity Type: Organization
Organization Name: Green Haven Group Home
Primary Specialty: Assisted Living Facility
Enumeration Date: Aug 9, 2023
Last Updated: Aug 9, 2023

Practice Location

Address: 3111 CREEKWOOD DR
City: Wylie
State: Texas
ZIP Code: 75098-7339
Phone: (408) 561-2324

Authorized Official

Name: ALI ADEM
Title: MANAGER
Phone: (408) 561-2324

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Assisted Living Facility	310400000X	Primary

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