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General NPI Number Information
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NPI Number | 1144043969
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Entity Type | Organization
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Legal Business Name | CLARA HAVEN LLC
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 2002 VILLAGE GREEN DR
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City | GARLAND
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State | TX
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Zip | 75044-7142
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Country | US
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Telephone | 214-991-8235
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Fax |
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Provider Business Mailing Address
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Address Line | 2002 VILLAGE GREEN DR
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City | GARLAND
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State | TX
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Zip | 75044-7142
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Country | US
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Telephone | 214-991-8235
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | ANDREA OSATO OSUNBOR
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Credential | COTA
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Telephone | 214-991-8235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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