MEDICARE: GRIFFIN HOME CARE HAVEN

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	310400000X	Assisted Living Facility	142149	TX
2	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1023204179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRIFFIN HOME CARE HAVEN

Provider Business Mailing Address
First Line	:	1208 WHISPERING CIR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-2035
Country	:	US
Telephone Number	:	214-372-6831
Fax Number	:	214-372-1743

Provider Business Practice Location Address
First Line	:	1208 WHISPERING CIR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-2035
Country	:	US
Telephone Number	:	214-372-6831
Fax Number	:	214-372-1743

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DARRENCE E GRIFFIN SR.
Credential	:
Telephone Number	:	214-725-8332

Provider Enumeration Date	:	09/22/2007
Last Update Date	:	11/15/2023

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Directions to “GRIFFIN HOME CARE HAVEN ” Practice Location

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