Organization
AUTUMN HAVEN RESIDENTIAL FACILITY
Active
Other names
Habor Haven Home Healthcare Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA DENNIS (OWNER)
(469) 254-1298
Entity
Organization
Contact information
Practice address
2507 EARLCOVE DR, DALLAS, TX 75227-7817
(469) 992-0389
(972) 637-9225
Mailing address
2507 EARLCOVE DR, DALLAS, TX 75227-7817
(469) 992-0389
(972) 637-9225
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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