MEDICARE: ABAHAVEN LIVING 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
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1407713480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABAHAVEN LIVING LLC

Provider Business Mailing Address
First Line	:	14930 WALTERS RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-2502
Country	:	US
Telephone Number	:	401-369-3743
Fax Number	:

Provider Business Practice Location Address
First Line	:	14930 WALTERS RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-2502
Country	:	US
Telephone Number	:	401-369-3743
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM MANAGER
Name	:	RIHANOT LAWAL
Credential	:
Telephone Number	:	401-369-3743

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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Directions to “ABAHAVEN LIVING LLC ” Practice Location

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