# MINDHAVEN HEALTHCARE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760213888
- **Authorized official:** FELIX OSEGBOUN (MANAGING DIRECTOR)
- **Authorized official phone:** (361) 389-2387

## Contact information

- **Practice address:** 8130 HICKORY HOLLOW DR, GLEN BURNIE, MD 21060-8640
- **Practice address phone:** (361) 389-2387
- **Mailing address:** 8130 HICKORY HOLLOW DR, GLEN BURNIE, MD 21060-8640
- **Mailing address phone:** (361) 389-2387

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 08/10/2024
- **Last updated:** 11/02/2024