MEDICARE: ARRYS HAVEN, 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1144183914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARRYS HAVEN, LLC

Provider Business Mailing Address
First Line	:	707 AUDREY LN
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-5328
Country	:	US
Telephone Number	:	619-414-4303
Fax Number	:	682-226-6086

Provider Business Practice Location Address
First Line	:	707 AUDREY LN
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-5328
Country	:	US
Telephone Number	:	619-414-4303
Fax Number	:	682-226-6086

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	OLUWASEYI TAMI YOUNG-HARRY
Credential	:	DHA
Telephone Number	:	619-424-4303

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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