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NPI Code Detail

MEDICARE: PROVIDENCE EVERLY HAVEN HOME HEALTHCARE, LLC

MEDICARE: PROVIDENCE EVERLY HAVEN HOME HEALTHCARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1245185016
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROVIDENCE EVERLY HAVEN HOME HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 5038 MINT ORCHARD DR
Second Line :
City : HOUSTON
State : TX
Zip : 77066-2570
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5038 MINT ORCHARD DR
Second Line :
City : HOUSTON
State : TX
Zip : 77066-2570
Country : US
Telephone Number : 713-865-2068
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MARKAYLA MARTINEZ
Credential :
Telephone Number : 713-865-2068
Provider Enumeration Date : 02/26/2026
Last Update Date : 02/26/2026

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Directions to “PROVIDENCE EVERLY HAVEN HOME HEALTHCARE, LLC ” Practice Location

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