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General NPI Number Information
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NPI Number | 1992340822
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Entity Type | Organization
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Legal Business Name | HAVEN OF MEMORABLE EXPERIENCES INC
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 5536 TREMPER ST
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City | HOUSTON
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State | TX
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Zip | 77020-4747
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Country | US
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Telephone | 832-715-9100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 202061
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City | HOUSTON
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State | TX
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Zip | 77220-2061
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Country | US
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Telephone | 832-715-9100
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Fax |
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Authorized Official
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Title or Position | FOUNDER/DIRECTOR
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Name | DEBBIE N GIBSON
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Credential |
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Telephone | 713-591-7782
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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