Healthcare Provider Details

I. General information

NPI: 1942138169
Provider Name (Legal Business Name): SAFE HAVEN HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 YALE SQUARE CT
KATY TX
77449-2097
US

IV. Provider business mailing address

4011 YALE SQUARE CT
KATY TX
77449-2097
US

V. Phone/Fax

Practice location:
  • Phone: 832-352-8463
  • Fax:
Mailing address:
  • Phone: 832-352-8463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: OLUTOBI IDOWU
Title or Position: CEO
Credential: MS, BCBA, LBA
Phone: 832-352-8463